1649525544 NPI number — COMMUNITY MEDICAL CENTERS, INC

Table of content: DR. DAVID NICKERSON TAFT DMD (NPI 1144231234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649525544 NPI number — COMMUNITY MEDICAL CENTERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY MEDICAL CENTERS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649525544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7210 MURRAY DR
Provider Second Line Business Mailing Address:
PO BOX 779
Provider Business Mailing Address City Name:
STOCKTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95210-3339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-373-2800
Provider Business Mailing Address Fax Number:
209-373-2878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
423 S SAN JOAQUIN ST
Provider Second Line Business Practice Location Address:
COMMUNITY MEDICAL CENTERS GLEASON
Provider Business Practice Location Address City Name:
STOCKTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95203-3537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-954-7700
Provider Business Practice Location Address Fax Number:
209-954-7750
Provider Enumeration Date:
07/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
NOGUERA
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
209-373-2831

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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