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NPI Code Detail

MEDICARE: DR. MICHAEL DENNIS FOX MD

MEDICARE: DR. MICHAEL DENNIS FOX MD
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
1207QA0401XAddiction Medicine (Family Medicine) PhysicianG53561CA
2207Q00000XFamily Medicine PhysicianG53561CA

General Provider Information

NPI Number : 1912069758
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL DENNIS FOX MD
Provider Business Mailing Address
First Line : 1839 S EL DORADO ST
Second Line :
City : STOCKTON
State : CA
Zip : 95206-2025
Country : US
Telephone Number : 209-463-0872
Fax Number : 209-466-4446
Provider Business Practice Location Address
First Line : 1839 S EL DORADO ST
Second Line :
City : STOCKTON
State : CA
Zip : 95206-2025
Country : US
Telephone Number : 209-463-0872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 10/15/2019

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Directions to “ DR. MICHAEL DENNIS FOX MD” Practice Location

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