Healthcare Provider Details

I. General information

NPI: 1659567923
Provider Name (Legal Business Name): MR. CURTIS SAXTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 N PERSHING AVE STE A6
STOCKTON CA
95207-4948
US

IV. Provider business mailing address

5665 N PERSHING AVE STE A6
STOCKTON CA
95207-4948
US

V. Phone/Fax

Practice location:
  • Phone: 209-477-3032
  • Fax: 209-411-3049
Mailing address:
  • Phone: 209-477-3032
  • Fax: 209-411-3049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHY45427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: