| Lodi Children's Clinic | |
|
1920 Tienda Dr Suite 102 Lodi CA 95242-3930 | |
| (209) 368-8310 | |
| (209) 368-9652 |
| Full Name | Lodi Children's Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1920 Tienda Dr, Lodi, California |
| Authorized Official Name and Position | Roy Anunciacion (PRESIDENT) |
| Authorized Official Contact | 2093688310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodi Children's Clinic 1920 Tienda Dr Suite 102 Lodi CA 95242-3930 | Lodi Children's Clinic 1920 Tienda Dr Suite 102 Lodi CA 95242-3930 Ph: (209) 368-8310 |
| NPI Number | 1235203688 |
|---|---|
| Provider Enumeration Date | 11/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235203688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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