institution
Lodi Memorial Hospital Association Inc
Primary Care Clinic/Center in Lodi, California
NPI 1306855523

Lodi Memorial Hospital Association Inc is a Primary Care Clinic/Center based in Los Angeles, CA and is specialized in Primary Care. Lodi Memorial Hospital Association Inc practices in Lodi, CA. The NPI Number for Lodi Memorial Hospital Association Inc is 1306855523 and holds a License No. 030000056 (California).

The current practice location address for Lodi Memorial Hospital Association Inc is 2415 W Vine St Ste 105, Lodi, CA and can be reached out via phone at 209-333-3121 and via fax at 209-339-7659.

Location: 2415 W Vine St Ste 105, Lodi, CA, 90088-4577
institution
Provider Profile Details
NPI Number
1306855523
Provider Name
Lodi Memorial Hospital Association Inc
Credential
Provider Entity Type
Organization
Address
2415 W Vine St Ste 105, Lodi, CA, 90088-4577
Phone Number
209-333-3121
Fax Number
209-339-7659
Provider Enumeration Date
08/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ53358Z 01 CA BLUE SHIELD PROV GRP
GR0086832 05 CA
institution
Provider Business Practice Location Address Details
Address
2415 W Vine St Ste 105
City
State
Zip
95242-3731
Phone Number
209-333-3121
Fax Number
209-339-7659
person
Provider Business Mailing Address Details
Address
2415 W Vine St Ste 105
City
State
Zip
95242-3731
Phone Number
209-333-3121
Fax Number
209-339-7659
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
030000056 (California)
Definition
Definition to come...
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