Jerome M. McDonald, M.D. Inc.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

C52651 Issued in CA

Legal business name

JEROME M. MCDONALD, M.D. INC.

Practice address

1617 N California St
Suite 1D
Stockton, CA 95204-6117

Phone

(209) 948-1234

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Jerome M McDonald

Title

Surgeon

Phone

(209) 948-1234

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851424410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 N CALIFORNIA ST",
            "address_2": "SUITE 1D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046117",
            "telephone_number": "209-948-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N CALIFORNIA ST",
            "address_2": "SUITE 1D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046117",
            "telephone_number": "209-948-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME M. MCDONALD, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "209-948-1234"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "C52651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.