Healthcare Provider Details

I. General information

NPI: 1386508331
Provider Name (Legal Business Name): RAO MEDICAL A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 W HAMMER LN
STOCKTON CA
95209-3011
US

IV. Provider business mailing address

1148 W HAMMER LN
STOCKTON CA
95209-3011
US

V. Phone/Fax

Practice location:
  • Phone: 512-850-5565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAHIL RAO
Title or Position: CEO
Credential: MD
Phone: 512-850-5565