Healthcare Provider Details
I. General information
NPI: 1770080954
Provider Name (Legal Business Name): MANVEER SINGH DILTS-GARCHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/12/2018
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1805 N CALIFORNIA ST STE 201
STOCKTON CA
95204-6032
US
IV. Provider business mailing address
1805 N CALIFORNIA ST STE 201
STOCKTON CA
95204-6032
US
V. Phone/Fax
- Phone: 209-645-4005
- Fax:
- Phone: 209-645-4005
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | A166089 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: