| Dameron Medical Group, Inc. | |
|
530 W Acacia St Stockton CA 95203-2454 | |
| (209) 461-3196 | |
| (209) 461-7593 |
| Full Name | Dameron Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 530 W Acacia St, Stockton, California |
| Authorized Official Name and Position | Lorraine P. Auerbach (SECRETARY) |
| Authorized Official Contact | 2094613100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dameron Medical Group, Inc. 420 W Acacia St Suite 13 Stockton CA 95203-2441 Ph: (209) 461-3196 | Dameron Medical Group, Inc. 530 W Acacia St Stockton CA 95203-2454 Ph: (209) 461-3196 |
| NPI Number | 1033544325 |
|---|---|
| Provider Enumeration Date | 09/05/2013 |
| Last Update Date | 09/13/2013 |
| Medicare PECOS PAC ID | 3971727967 |
|---|---|
| Medicare Enrollment ID | O20140701000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033544325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Troy L Manchester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689692139 PECOS PAC ID: 7012905953 Enrollment ID: I20040430001365 |
| Provider Name | Devinder K Makker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568421030 PECOS PAC ID: 6002891314 Enrollment ID: I20040622000392 |
| Provider Name | Paulo Postiglione |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952487233 PECOS PAC ID: 9133105109 Enrollment ID: I20040629000846 |
| Provider Name | Venkatramana Srinivasan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578576591 PECOS PAC ID: 8022075282 Enrollment ID: I20041220000428 |
| Provider Name | Michael D Hurst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205893104 PECOS PAC ID: 1052397742 Enrollment ID: I20051014000212 |
| Provider Name | Ramana Adapa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407959315 PECOS PAC ID: 3870663404 Enrollment ID: I20080609000208 |
| Provider Name | Raman S Grewal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023000270 PECOS PAC ID: 3577542224 Enrollment ID: I20090108000082 |
| Provider Name | Zeest Khan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780872192 PECOS PAC ID: 4880877273 Enrollment ID: I20110322000980 |
| Provider Name | Diego F Ferro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700027877 PECOS PAC ID: 2769660877 Enrollment ID: I20110620000527 |
| Provider Name | Mohammad Haghdoost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710291570 PECOS PAC ID: 0840478723 Enrollment ID: I20110624000449 |
| Provider Name | Rahul R Gohil |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679754873 PECOS PAC ID: 6608035134 Enrollment ID: I20120302000040 |
| Provider Name | Abnet A Alemu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316123383 PECOS PAC ID: 6103087606 Enrollment ID: I20120410000366 |
| Provider Name | Deandrea Lavon Sims |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619113925 PECOS PAC ID: 9931365103 Enrollment ID: I20120717000273 |
| Provider Name | Alan Dale Sabino |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831179845 PECOS PAC ID: 1355311721 Enrollment ID: I20121214000313 |
| Provider Name | Jennifer Jean Mcneil |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1366465841 PECOS PAC ID: 9234108275 Enrollment ID: I20150113000979 |
| Provider Name | Yasuhiro Shudo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1184004061 PECOS PAC ID: 9931412103 Enrollment ID: I20150716001885 |
| Provider Name | Tuan Ngoc Hoang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265590905 PECOS PAC ID: 7618272568 Enrollment ID: I20160301002462 |
| Provider Name | Victor L Beer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518324771 PECOS PAC ID: 1850699786 Enrollment ID: I20160411000323 |
| Provider Name | Devin S Zarkowsky |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689925844 PECOS PAC ID: 8325297237 Enrollment ID: I20160721002694 |
| Provider Name | Amelia Claire Watkins |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1558596213 PECOS PAC ID: 0749589513 Enrollment ID: I20170626002732 |
| Provider Name | Maria E Currie |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1568986818 PECOS PAC ID: 2466728555 Enrollment ID: I20171017002395 |
| Provider Name | Michael P Moneyhon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467712018 PECOS PAC ID: 6103182514 Enrollment ID: I20171116003140 |
| Provider Name | Dinesh Vyas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528274503 PECOS PAC ID: 9931252731 Enrollment ID: I20171122002223 |
| Provider Name | Shaun Michael Gifford |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558576918 PECOS PAC ID: 1951557065 Enrollment ID: I20171128003755 |
| Provider Name | John Ward Macarthur |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891957106 PECOS PAC ID: 3173871415 Enrollment ID: I20180802003662 |
| Provider Name | John P Chunga |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730259714 PECOS PAC ID: 6901884360 Enrollment ID: I20190228001714 |
| Provider Name | Billie-jean Martin |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1609284629 PECOS PAC ID: 5395017776 Enrollment ID: I20191014001860 |
| Provider Name | Thomas Heafner |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396030102 PECOS PAC ID: 2365710118 Enrollment ID: I20191210002550 |
| Provider Name | Marilee Carballo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033348578 PECOS PAC ID: 8123351129 Enrollment ID: I20200226002705 |
| Provider Name | Anders John Davidson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881957694 PECOS PAC ID: 9830493535 Enrollment ID: I20220114002049 |
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