Healthcare Provider Details

I. General information

NPI: 1497634240
Provider Name (Legal Business Name): OAK HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2339 W HAMMER LN STE J
STOCKTON CA
95209-2368
US

IV. Provider business mailing address

2339 W HAMMER LN STE J
STOCKTON CA
95209-2368
US

V. Phone/Fax

Practice location:
  • Phone: 209-477-7100
  • Fax: 209-477-7111
Mailing address:
  • Phone: 209-477-7100
  • Fax: 209-477-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AMIR TAJ KHAN
Title or Position: PHARMACIST / PHARMACY MANAGER
Credential: PHARM.D.
Phone: 209-471-5426