CMC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA22498 Issued in CA

Legal business name

CMC

Practice address

1801 E March LN Ste D470
Stockton, CA 95210-6677

Phone

(209) 507-7000

Fax

(209) 507-7550

NPI assigned

Jan 13, 2016

Last updated

Jan 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jackson David Fraser

Title

PA-C

Phone

(209) 507-7000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1699131110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE D470",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106677",
            "telephone_number": "209-507-7000",
            "fax_number": "209-507-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE D470",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106677",
            "telephone_number": "209-507-7000",
            "fax_number": "209-507-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "209-507-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Jan Tan Clemente
• Cesar Alonzo Clemente
• Bryan Christopher Clements, MD
• Suzanna Cloward
• Dindo Angeles Clutario
• CMT Medical Transport Solutions, LLC
• Johnston Co, M.D.
• Coast to Coast DME
• Timothy McCarty Coats, MD
• Leif Bradly Cobain, DDS

• Medical Physician Assistant in Stockton, CA
• Providers in Stockton, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.