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General NPI Number Information
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NPI Number | 1528190931
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Entity Type | Organization
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Legal Business Name | PORT CITY OPERATING COMPANY, LLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1800 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204-6019
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Country | US
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Telephone | 858-275-8112
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Fax | 779-803-8118
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Provider Business Mailing Address
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Address Line | P O BOX 213008
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City | STOCKTON
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State | CA
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Zip | 95213-9008
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Country | US
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Telephone | 858-275-8112
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Fax | 779-803-8118
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DANIEL MORISETTE
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Credential |
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Telephone | 858-275-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 030000284
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 030000284
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License Number State | CA
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