Lodi Children's Clinic Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LODI CHILDREN'S CLINIC MEDICAL CORPORATION

Doing business as

Lodi Children's Clinic

Practice address

1920 Tienda Dr
Suite 102
Lodi, CA 95242-3930

Phone

(209) 368-8310

Fax

(209) 368-9652

NPI assigned

Nov 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Roy AnunciacionNPI 1205839735

Title

President

Phone

(209) 368-8310

Specialties & licenses 1

Addresses

Other names 1

• LODI CHILDREN'S CLINIC Doing business as

Locations

Practitioners 1

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

• Roy Anunciacion, M.D.

  • Pediatrics Physician
  • Lodi, CA
  • NPI 1205839735
  NPD (past) Authorized official

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

{
    "created_epoch": "1163894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235203688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 TIENDA DR",
            "address_2": "SUITE 102",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 TIENDA DR",
            "address_2": "SUITE 102",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423930",
            "telephone_number": "209-368-8310",
            "fax_number": "209-368-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI CHILDREN'S CLINIC MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANUNCIACION",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-368-8310",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LODI CHILDREN'S CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda L. Wolff
• Heather Michelle Link
• La Toya Littesy, AMFT
• Nancy A. Little, M.D.
• Lodi Advanced Medical Center PC
• Lodi Delta Emergency Physicians
• Lodi Dental Group
• Lodi Drug Company, Inc
• Lodi Health
• Lodi Kids Dentist a Professional Dental Corporation (Lodi Kids Dentist A Professional Dental Corporation DBA Lodi Kidz Dentist)

• Primary Care Clinic/Center in Lodi, CA
• Providers in Lodi, CA by specialty
• Primary Care Clinic/Center in California

• 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.