Healthcare Provider Details

I. General information

NPI: 1992176341
Provider Name (Legal Business Name): ALMASTRO DENNY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1149 N EL DORADO ST
STOCKTON CA
95202-1305
US

IV. Provider business mailing address

1149 N EL DORADO ST
STOCKTON CA
95202-1305
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-2337
  • Fax:
Mailing address:
  • Phone: 209-468-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: