Provider Demographics
NPI:1194856914
Name:MEHERJI OSHTORY MD & ABHA OSHTORY MD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:MEHERJI OSHTORY MD & ABHA OSHTORY MD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHERJI
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSHTORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-944-5730
Mailing Address - Street 1:2626 N CALIFORNIA ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5500
Mailing Address - Country:US
Mailing Address - Phone:209-944-5730
Mailing Address - Fax:209-944-0129
Practice Address - Street 1:2626 N CALIFORNIA ST
Practice Address - Street 2:SUITE I
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5500
Practice Address - Country:US
Practice Address - Phone:209-944-5730
Practice Address - Fax:209-944-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA257912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A257910Medicare ID - Type Unspecified
CA00A261980Medicare ID - Type Unspecified