Stan Elijah, MT

NPI 1821329418 · on the registry since 2010 · sole proprietor

Practice

Address: 4565 Quail Lakes Dr Ste A1
Stockton, CA 95207
Phone: (209) 888-8602
Fax: (209) 888-8603
Organisation at this address: Jasbir Cheema Dental Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 173C00000X
173C00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2010-01-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California