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General NPI Number Information
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NPI Number | 1366210478
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL TEAM ACUTE CARE CORPORATION
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 768 MOUNTAIN RANCH RD
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City | SAN ANDREAS
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State | CA
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Zip | 95249-9707
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Country | US
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Telephone | 209-915-6505
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Fax | 209-464-0193
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Provider Business Mailing Address
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Address Line | 1801 E MARCH LN STE C300
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City | STOCKTON
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State | CA
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Zip | 95210-6657
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Country | US
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Telephone | 209-464-6422
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Fax | 209-464-0193
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANJEEV K GOSWAMI
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Credential | MD
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Telephone | 209-310-6156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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