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NPI Code Detail

MEDICARE: COMMUNITY MEDICAL TEAM, INC.

MEDICARE: COMMUNITY MEDICAL TEAM, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1306521422
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEDICAL TEAM, INC.
Provider Business Mailing Address
First Line : 1148 W HAMMER LN
Second Line :
City : STOCKTON
State : CA
Zip : 95209-3011
Country : US
Telephone Number : 209-952-9696
Fax Number :
Provider Business Practice Location Address
First Line : 1148 W HAMMER LN
Second Line :
City : STOCKTON
State : CA
Zip : 95209-3011
Country : US
Telephone Number : 209-952-9696
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SANJEEV GOSWAMI
Credential : MD
Telephone Number : 209-464-6422
Provider Enumeration Date : 06/16/2023
Last Update Date : 04/03/2025

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Directions to “COMMUNITY MEDICAL TEAM, INC. ” Practice Location

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