Edward Joseph Stanford, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

59064 Issued in CA

Practice address

1262 E North St
Manteca, CA 95336

Phone

(209) 823-7646

Fax

(209) 824-5374

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: estanford457546@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DHP of California Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Stockton, CA
  • NPI 1679836084
  Medicare reassignment NPD
• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  Medicare reassignment NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Magella Medical Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Long Beach, CA
  • NPI 1376640086
  Medicare reassignment NPD
• Obstetrix Medical Group of Sacramento, P.C.

  • Maternal & Fetal Medicine Physician
  • Orange, CA
  • NPI 1144593310
  Medicare reassignment NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862

  Surgery

  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1265030886
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)
• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807

  Surgery

  NPD (past)
• Southern Illinois Physician Services, PC

  • Gastroenterology Physician
  • Belleville, IL
  • NPI 1508953746

  Gynecology

  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1326094715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364962",
            "telephone_number": "209-823-7646",
            "fax_number": "209-824-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1262 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95336",
            "telephone_number": "209-823-7646",
            "fax_number": "209-824-5374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "IL",
            "postal_code": "628013902",
            "country_code": "US",
            "telephone_number": "618-532-7891",
            "fax_number": "618-532-7923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "IL",
            "postal_code": "628013902",
            "country_code": "US",
            "telephone_number": "618-532-7891",
            "fax_number": "618-532-7923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036080278",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036080278",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "59064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080278",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE #",
            "identifier": "212529",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calli Sierra Souza
• Kraianne Thompson Souza
• Mayra Alejandra Souza
• Jennah N Sparaco
• Preeti J. Srivatsa, MD
• Aniyah Stanley
• Stavros Stathoudakis, PHARMD
• Frederick William Stellhorn, O.D.
• Cheryl Ann Striplin, PHARMD.
• Ching-Fang Sun, MD

• Gynecology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.