Organization Active NPI

Madelaine Aquino, M.D. Inc.

  • Clinic/Center
  • Stockton, CA
National Provider Identifier
1518188366
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
07-00087928 Issued in CA
Legal business name
MADELAINE AQUINO, M.D. INC.
Practice address
10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286
Phone
(209) 943-6740
Fax
(209) 943-6744
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Authorized official

Name
Dr. Madelaine Mabunga Aquino, M.D.NPI 1841379856
Title
President
Phone
(209) 943-6740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 07-00087928 CA Primary

Addresses

Primary practice location

10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286

Mailing address

10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286
Phone (209) 943-6740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070604000700 CA Part B Supplier - Clinic/Group Practice 8224136957 Receives reassigned benefits from 1 practitioner
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

2626 N California St
Ste C
Stockton, CA 95204
Phone (209) 465-7463

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1518188366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY",
            "address_2": "SUITE 207",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197286",
            "telephone_number": "209-943-6740",
            "fax_number": "209-943-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY",
            "address_2": "SUITE 207",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197286",
            "telephone_number": "209-943-6740",
            "fax_number": "209-943-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADELAINE AQUINO, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "MADELAINE",
        "authorized_official_middle_name": "MABUNGA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-943-6740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "07-00087928",
            "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 Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.