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institution
Lodi Memorial Hospital Association Inc
Clinic/Center in Lodi, California
NPI 1386654077

Lodi Memorial Hospital Association Inc is a Clinic/Center based in Los Angeles, CA. Lodi Memorial Hospital Association Inc practices in Lodi, CA. The NPI Number for Lodi Memorial Hospital Association Inc is 1386654077 and holds a License No. 030000056 (California).

The current practice location address for Lodi Memorial Hospital Association Inc is 2415 W Vine St Ste 100, Lodi, CA and can be reached out via phone at 209-333-3135 and via fax at 209-339-7659.

Location: 2415 W Vine St Ste 100, Lodi, CA, 90088-4577
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1386654077
Provider Name
Lodi Memorial Hospital Association Inc
Credential
Provider Entity Type
Organization
Address
2415 W Vine St Ste 100, Lodi, CA, 90088-4577
Phone Number
209-333-3135
Fax Number
209-339-7659
Provider Enumeration Date
08/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ02721Z 01 CA BLUE SHIELD PROV GRP
GR0086831 05 CA
institution
Provider Business Practice Location Address Details
Address
2415 W Vine St Ste 100
City
Lodi
State
California
Zip
95242-3731
Phone Number
209-333-3135
Fax Number
209-339-7659
person
Provider Business Mailing Address Details
Address
2415 W Vine St Ste 100
City
Lodi
State
California
Zip
95242-3731
Phone Number
209-333-3135
Fax Number
209-339-7659
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
030000056 (California)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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