Stockton Nephrology, Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A111373 Issued in CA

Legal business name

STOCKTON NEPHROLOGY, INC.

Practice address

1525 N El Dorado St
Suite 1
Stockton, CA 95204-5932

Phone

(209) 465-5107

Fax

(209) 465-7653

NPI assigned

Sep 7, 2013

Last updated

Feb 3, 2017By 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

Lan Ngoc Quang, M.D.NPI 1437354347

Title

President

Phone

(415) 283-5772

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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.

• Lan Ngoc Quang, M.D.

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1437354347
  Medicare reassignment NPD Authorized official
• George Herron, M.D.

  • Nephrology Physician
  • Stockton, CA
  • NPI 1144217654
  NPD (past)
• Jerry Soung, M.D.

  • Nephrology Physician
  • Stockton, CA
  • NPI 1154318764
  NPD (past)
• Lian Soung, M.D.

  • Nephrology Physician
  • Stockton, CA
  • NPI 1174510747
  NPD (past)

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

{
    "created_epoch": "1378512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1790110880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 N EL DORADO ST",
            "address_2": "SUITE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045932",
            "telephone_number": "209-465-5107",
            "fax_number": "209-465-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 N EL DORADO ST",
            "address_2": "SUITE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045932",
            "telephone_number": "209-465-5107",
            "fax_number": "209-465-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON NEPHROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-07",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "QUANG",
        "authorized_official_first_name": "LAN",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-283-5772",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A111373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stockton Injury Center
• Stockton Kidney Clinic, LLC (Stockton Kidney Clinic)
• Stockton Lymphedema Therapy and Physical Rehabilitation
• Stockton Medical Weight Loss Center Inc (Pacific Medical Weight Loss)
• Stockton MRI & Molecular Imaging Medical Center Inc
• Stockton Neurological Medical Clinic, Inc
• Stockton Nursing and Rehab Center LLC (Stockton Nursing Center)
• Stockton Orthopedic Medical Group, Inc.
• Stockton Outpatient Surgery Center LLC (Ambulatory Surgery Center of Stockton)
• Stockton Pace, LLC

• Nephrology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.