NPIMap

Organization Active NPI

Public Health Lab, San Joaquin Co Pub HLTH SVS

  • Clinical Medical Laboratory
  • Stockton, CA
National Provider Identifier
1114060522
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PUBLIC HEALTH LAB, SAN JOAQUIN CO PUB HLTH SVS
Practice address
1601 E Hazelton Ave
Stockton, CA 95205-6229
Phone
(209) 468-3413
Fax
(209) 468-2072
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. William Mitchell, MPH
Title
Director Public Health Services
Phone
(209) 468-3413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1601 E Hazelton Ave
Stockton, CA 95205-6229

Mailing address

PO Box 2009
Stockton, CA 95201-2009
Phone (209) 468-3413

National Provider Directory

National Provider Directory
Tax ID family
San Joaquin Cnty HLTH94 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114060522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2009",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952012009",
            "telephone_number": "209-468-3413",
            "fax_number": "209-468-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E HAZELTON AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952056229",
            "telephone_number": "209-468-3413",
            "fax_number": "209-468-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH LAB, SAN JOAQUIN CO PUB HLTH SVS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR PUBLIC HEALTH SERVICES",
        "authorized_official_telephone_number": "209-468-3413",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.