Healthcare Provider Details

I. General information

NPI: 1104840800
Provider Name (Legal Business Name): DENNY SCHOCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 S FAIRMONT AVE SUITE 100
LODI CA
95240-5100
US

IV. Provider business mailing address

PO BOX 241011
LODI CA
95241-9511
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-2010
  • Fax: 209-334-0132
Mailing address:
  • Phone: 209-339-7435
  • Fax: 209-339-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA95138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: