Delta Heart & Medical Clinic, Inc.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

A48005 Issued in CA

Legal business name

DELTA HEART & MEDICAL CLINIC, INC.

Practice address

1801 E March LN
A-170
Stockton, CA 95210-6629

Phone

(209) 951-9884

Fax

(209) 951-7873

NPI assigned

Apr 6, 2007

Last updated

Oct 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bunmi Olowoyeye

Title

Administrator

Phone

(209) 951-9884

Specialties & licenses 2

Addresses

Other identifiers 6

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John O Olowoyeye, MD

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1336256726
  NPD (past)
• Sujeeth Reddy Punnam, M.D.

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1932294253
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1013030006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "A-170",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-951-9884",
            "fax_number": "209-951-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "A-170",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-951-9884",
            "fax_number": "209-951-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEART & MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "OLOWOYEYE",
        "authorized_official_first_name": "BUNMI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-951-9884"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A48005",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A48005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A480050",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "OOA480050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ64420Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HILL PHYSICIANS MED GROUP",
            "identifier": "037196",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6923038",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DC3822",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurora Delsolar
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• Delta Eye Medical Group, Inc.
• Delta Health Care and Managment Services Corp.
• Delta Housing Solutions, LLC (Delta Housing Solutions)
• Delta Pathology Associates Medical Group Inc
• Delta Podiatry Group, Inc.
• Delta Radiology Medical Group Inc
• Delta Radiology Medical Group, Inc.

• Interventional Cardiology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.