MEDICARE: ST.JOSEPHS MEDICAL ASSOCIATES 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
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922010222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST.JOSEPHS MEDICAL ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	1805 N CALIFORNIA ST STE 201
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-6032
Country	:	US
Telephone Number	:	209-939-3840
Fax Number	:	209-463-4254

Provider Business Practice Location Address
First Line	:	1805 N CALIFORNIA ST STE 201
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-6032
Country	:	US
Telephone Number	:	209-939-3840
Fax Number	:	209-463-4254

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAUKAT A SHAH
Credential	:	MD
Telephone Number	:	209-939-3840

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	09/11/2025

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