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Contact Information

JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION
525 W ACACLA ST
STOCKTON, CA95203
 Phone: 469-401-2386
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION

NPI # 1194251595
LBN Legal business name JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION
Authorized official KATHLEEN KONDAS - (VP PROVIDER ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/04/2017
Last updated 10/23/2019 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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