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General NPI Number Information
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NPI Number | 1841780301
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN CRITICAL CARE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1801 E MARCH LN STE C300 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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Provider Business Mailing Address
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Address Line | 4401 W MEMORIAL RD STE 121
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1722
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Country | US
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Telephone | 405-751-4664
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Fax | 405-751-3183
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANJEEV K GOSWAMI
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Credential | MD
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Telephone | 209-464-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 4061528
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License Number State | CA
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