Stockton Medical Weight Loss Center Inc

Primary specialty

Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X

License

G68135 Issued in CA

Legal business name

STOCKTON MEDICAL WEIGHT LOSS CENTER INC

Doing business as

Pacific Medical Weight Loss

Practice address

1801 E. March Lane
Suite 400D
Stockton, CA 95210

Phone

(209) 242-3334

NPI assigned

Mar 17, 2010

Last updated

Mar 17, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

STOCKTON MEDICAL WEIGHT LOSS CENTER INCAs reported in NPPES

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

Authorized official

Name

Dr. Daren Stephen Primack, MDNPI 1215905260

Title

Owner

Phone

(209) 242-3334

Specialties & licenses 1

Addresses

Other names 1

• Pacific Medical Weight Loss Doing business as

Part of

Stockton Medical Weight Loss Center Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daren Stephen Primack, MD

  • Phlebology Physician
  • Stockton, CA
  • NPI 1215905260
  NPD (past) Authorized official

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1770807901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E. MARCH LANE",
            "address_2": "SUITE 400D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95210",
            "telephone_number": "209-242-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E. MARCH LANE",
            "address_2": "SUITE 400D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95210",
            "telephone_number": "209-242-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON MEDICAL WEIGHT LOSS CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STOCKTON MEDICAL WEIGHT LOSS CENTER INC",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "PRIMACK",
        "authorized_official_first_name": "DAREN",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-242-3334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "CA",
            "license": "G68135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Medical Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stockton Heritage Partners, LLC
• Stockton Hospitalist Medical Group, Inc.
• Stockton Injury Center
• Stockton Kidney Clinic, LLC (Stockton Kidney Clinic)
• Stockton Lymphedema Therapy and Physical Rehabilitation
• Stockton MRI & Molecular Imaging Medical Center Inc
• Stockton Nephrology, Inc.
• Stockton Neurological Medical Clinic, Inc
• Stockton Nursing and Rehab Center LLC (Stockton Nursing Center)
• Stockton Orthopedic Medical Group, Inc.

• Obesity Medicine (Internal Medicine) Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Obesity Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.