| Kettleman Care Center | |
|
1335 S Fairmont Ave Lodi CA 95240-5520 | |
| (209) 366-2007 | |
| Not Available |
| Full Name | Kettleman Care Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1335 S Fairmont Ave, Lodi, California |
| Authorized Official Name and Position | Steven a Mitnick (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2095216097 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kettleman Care Center 600 Coffee Rd Modesto CA 95355-4201 Ph: (209) 524-1211 | Kettleman Care Center 1335 S Fairmont Ave Lodi CA 95240-5520 Ph: (209) 366-2007 |
| NPI Number | 1982648580 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 05/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982648580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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