Basic Information
| Provider Information | |||||||||
| NPI: | 1023196599 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZIOMEK | ||||||||
| FirstName: | CAMILLE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 779 | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952010779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093732800 | ||||||||
| FaxNumber: | 2093732873 | ||||||||
| Practice Location | |||||||||
| Address1: | 131 W A ST | ||||||||
| Address2: | |||||||||
| City: | DIXON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956203437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7076351600 | ||||||||
| FaxNumber: | 7076351641 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A8353 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.