Healthcare Provider Details

I. General information

NPI: 1063692440
Provider Name (Legal Business Name): JAMES PAUL CHING MAGANITO DO, MPH, MHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 N CALIFORNIA ST STE 2A
STOCKTON CA
95204-6117
US

IV. Provider business mailing address

PO BOX 1090
LODI CA
95241-1090
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-1800
  • Fax: 209-334-2416
Mailing address:
  • Phone: 209-334-1800
  • Fax: 209-334-2416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOP60106585
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101016513
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A11694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: