NPIMap

Organization Active NPI

Stockton Primary Care

  • Primary Care Clinic/Center
  • Lodi, CA
National Provider Identifier
1669743274
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
20440 Issued in CA
Legal business name
STOCKTON PRIMARY CARE
Practice address
2068 Snowbird Dr
Lodi, CA 95242-4754
Phone
(209) 333-0259
Fax
(209) 333-0259
NPI assigned
Jan 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Dr. Ragunath K Reddy, MD
Title
Family Practice
Phone
(209) 946-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 20440 CA Primary

Addresses

Primary practice location

2068 Snowbird Dr
Lodi, CA 95242-4754

Mailing address

1805 N California St Ste 102
Stockton, CA 95204-6032
Phone (209) 946-4000

National Provider Directory

National Provider Directory

Locations

1805 N California St
Ste 102
Stockton, CA 95204
Phone (209) 946-4000

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": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1669743274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 102",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046032",
            "telephone_number": "209-946-4000",
            "fax_number": "209-946-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2068 SNOWBIRD DR",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424754",
            "telephone_number": "209-333-0259",
            "fax_number": "209-333-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "RAGUNATH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FAMILY PRACTICE",
        "authorized_official_telephone_number": "209-946-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.