Stockton MRI & Molecular Imaging Medical Center Inc

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

00A323210 Issued in CA

Legal business name

STOCKTON MRI & MOLECULAR IMAGING MEDICAL CENTER INC

Practice address

2320 N California St
Suite B
Stockton, CA 95204-5506

Phone

(209) 466-2000

Fax

(209) 466-2600

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stan Fred Dobretz, B.S.R.T.

Title

Administrator

Phone

(209) 466-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin G Covington, M.D.

  • Nuclear Radiology Physician
  • Downey, CA
  • NPI 1891806311
  NPD (past)
• Oscar O Isidoro, MD

  • Radiology Clinic/Center
  • Stockton, CA
  • NPI 1588793103
  NPD (past)
• Tomislav Leskovar, M.D.

  • Diagnostic Radiology Physician
  • Moraga, CA
  • NPI 1265654172
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1073558656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 N CALIFORNIA ST",
            "address_2": "SUITE 2",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045509",
            "telephone_number": "209-466-2000",
            "fax_number": "209-466-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 N CALIFORNIA ST",
            "address_2": "SUITE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045506",
            "telephone_number": "209-466-2000",
            "fax_number": "209-466-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON MRI & MOLECULAR IMAGING MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "DOBRETZ",
        "authorized_official_first_name": "STAN",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-466-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S.R.T."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "CA",
            "license": "00A323210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stockton Orthopedic Medical Group, Inc.
• Stockton Outpatient Surgery Center LLC

• Magnetic Resonance Imaging (MRI) Clinic/Center in Stockton, CA
• Providers in Stockton, CA by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.