| Dr Daren Stephen Primack, MD | |
|
1801 E March Ln, Ste. D400, Stockton, CA 95210-6629 | |
| (209) 464-3615 | |
| (209) 464-1311 |
| Full Name | Dr Daren Stephen Primack |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 38 Years |
| Location | 1801 E March Ln, Stockton, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215905260 | NPI | - | NPPES |
| 00G681350 | Medicaid | CA | |
| G68135 | Other | CA | MEDICAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | G68135 (California) | Secondary |
| 202K00000X | Phlebology | G68135 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventist Health Lodi Memorial | Lodi, CA | Hospital |
| Dameron Hospital | Stockton, CA | Hospital |
| Mark Twain Medical Center | San andreas, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Adventist Health Physicians Network | 3274580972 | 572 |
| Lodi Memorial Hospital Association Inc | 7618880717 | 39 |
| Entity Name | Pacific Heart And Vascular Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649208463 PECOS PAC ID: 1658267190 Enrollment ID: O20040223001067 |
| Entity Name | Delta Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740305846 PECOS PAC ID: 5294795308 Enrollment ID: O20041013000834 |
| Entity Name | Adventist Health Physicians Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063718583 PECOS PAC ID: 3274580972 Enrollment ID: O20050407000633 |
| Entity Name | Lodi Memorial Hospital Association Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861649352 PECOS PAC ID: 7618880717 Enrollment ID: O20050517000577 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Daren Stephen Primack, MD 1801 E March Ln Ste D400, Stockton, CA 95210-6675 Ph: (209) 464-3615 | Dr Daren Stephen Primack, MD 1801 E March Ln, Ste. D400, Stockton, CA 95210-6629 Ph: (209) 464-3615 |