Healthcare Provider Details

I. General information

NPI: 1306283056
Provider Name (Legal Business Name): BRADLEY LYNN STOKER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 E ORANGEBURG AVE
MODESTO CA
95355-3370
US

IV. Provider business mailing address

2116 E ORANGEBURG AVE
MODESTO CA
95355-3370
US

V. Phone/Fax

Practice location:
  • Phone: 209-850-3500
  • Fax: 209-850-3499
Mailing address:
  • Phone: 209-850-3500
  • Fax: 209-850-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25113
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO206226
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: