Individual provider Active NPI

Caroline Tashdjian, MD

  • Internal Medicine Physician
  • Stockton, CA
National Provider Identifier
1609405042
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A187373 Issued in CA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 547-7177
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A187373 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

1800 N California St
Stockton, CA 95204-6019

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260112003707 CA Practitioner - Internal Medicine 4880170539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1601 Cummins Dr D
Modesto, CA 95358-6411

1812 Verdugo Blvd
Glendale, CA 91208-1409

2100 Powell St
Emeryville, CA 94608-1826

4549 Briggs Ave
LA Crescenta, CA 91214-3102

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A187373CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Jan 7, 2026 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jan 7, 2026 Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2975 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 522-2500

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1609405042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASHDJIAN",
        "first_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A187373",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.