Roy Blanco (NPI# 1417074907, PAC ID# 8628292075) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1417074907 |
| PAC ID by PECOS | 8628292075 |
| Professional Enrollment ID | I20150908002681 |
| Full Name | Roy Blanco |
| Organization Legal Name | LODI MEMORIAL HOSPITAL ASSOCIATION INC |
| Address |
10200 Trinity Pkwy Suite 102 Stockton CA 95219-7287 |
| Phone Number | 2093343411 |
| Gender | M |
| Graduation Year | 2006 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7618880717 |
| Number of Group Practice Members | 62 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050336 | ADVENTIST HEALTH LODI MEMORIAL |
| Address | Phone | Organization |
|---|---|---|
| 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 | 2093343411 | LODI MEMORIAL HOSPITAL ASSOCIATION INC |
| Organization Legal Name | LODI MEMORIAL HOSPITAL ASSOCIATION INC |
| Physicians | 59 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Armeghan Bagherpour | Physician Assistant | Lodi Memorial Hospital Association Inc | 305 Preston Ave, Ione, CA 95640-9158 |
| Abdul W Raif Jawid | Internal Medicine | Lodi Memorial Hospital Association Inc | 1901 W Kettleman Ln, Suite 200, Lodi, CA 95242-4337 |
| Craig W Hall | Family Medicine | Lodi Memorial Hospital Association Inc | 845 S Fairmont Ave, Suite 8, Lodi, CA 95240-5113 |
| Than Soe | Family Medicine | Lodi Memorial Hospital Association Inc | 2415 W Vine St, Suite 105, Lodi, CA 95242-3731 |
| Ranganathan G Madhavan | Internal Medicine | Lodi Memorial Hospital Association Inc | 975 S Fairmont Ave, Lodi, CA 95240-5118 |
| Sandra Robles-bonham | Physician Assistant | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| Juliene C Gentry | Internal Medicine | Lodi Memorial Hospital Association Inc | 975 S Fairmont Ave, Lodi, CA 95240-5118 |
| Steven D Laviola | Cardiovascular Disease (cardiology) | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| James M Myers | Physician Assistant | Lodi Memorial Hospital Association Inc | 2415 W Vine St, Suite 105, Lodi, CA 95242-3731 |
| Alex T Kelemework | Internal Medicine | Lodi Memorial Hospital Association Inc | 975 S Fairmont Ave, Lodi, CA 95240-5118 |
| Street Address |
10200 TRINITY PKWY SUITE 102 |
| City | STOCKTON |
| State | CA |
| Zip | 95219-7287 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Tersilla Ledda | Qualified Audiologist | Sacramento Ear Nose and Throat Surgical and Medical Group Inc | 10200 Trinity Pkwy, Suite 201, Stockton, CA 95219-7288 |
| Michelle M Rutherford | Physical Therapy | Jbjc Inc. | 10200 Trinity Pkwy, Suite 205, Stockton, CA 95219-7288 |
| Sandra Robles-bonham | Physician Assistant | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| Ronald George Dong | Otolaryngology | Sacramento Ear Nose and Throat Surgical and Medical Group Inc | 10200 Trinity Pkwy, Suite 201, Stockton, CA 95219-7288 |
| Steven D Laviola | Cardiovascular Disease (cardiology) | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| Gursharan Nahl | Internal Medicine | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| Michael A Ali | Emergency Medicine | 10200 Trinity Pkwy, Suite 202, Stockton, CA 95219-7288 | |
| James J Grady | Family Medicine | Lodi Memorial Hospital Association Inc | 10200 Trinity Pkwy, Suite 102, Stockton, CA 95219-7287 |
| Melissa Baxter | Certified Registered Nurse Anesthetist (crna) | Bay Area Anesthesia Associates | 10200 Trinity Pkwy, Suite 101, Stockton, CA 95219-7287 |
| Denise V Guendert | Otolaryngology | Sacramento Ear Nose and Throat Surgical and Medical Group Inc | 10200 Trinity Pkwy, Suite 201, Stockton, CA 95219-7288 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramesh N Dharawat | Cardiovascular Disease (cardiology) | 3503 Morningside Dr, Stockton, CA 95219-1740 | |
| Frank Callcott | Diagnostic Radiology | Radadvantage A Professional Corporation | 4682 Saint Andrews Dr, Stockton, CA 95219-1888 |
| Annapoorna Muthyapu | Family Medicine | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Thao Nguyen | Family Medicine | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Samira C Jahangiri | Family Medicine | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Anureet Kaur Gill | Family Medicine | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Anita D Heart | Family Medicine | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Lisa A Tabbit | Family Practice | Dignity Health Medical Foundation | 3132 W March Ln, Stockton, CA 95219-2354 |
| Ahmid Dredar | Family Practice | Dignity Health Medical Foundation | 3132 W March Ln, Suite 5, Stockton, CA 95219-2354 |
| Dolly Luong | Nurse Practitioner | Dignity Health Medical Foundation | 3132 W March Ln, Stockton, CA 95219-2354 |
| Find all physicians in zip 95219 | |||
| City | STOCKTON |
| Zip Code | 95219 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | STOCKTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Roy Blanco.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.