Basic Information
Provider Information
NPI: 1104840800
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOCH
FirstName: DENNY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 241011
Address2:  
City: LODI
State: CA
PostalCode: 952419511
CountryCode: US
TelephoneNumber: 2093397435
FaxNumber: 2093397858
Practice Location
Address1: 999 S FAIRMONT AVE
Address2: SUITE 100
City: LODI
State: CA
PostalCode: 952405100
CountryCode: US
TelephoneNumber: 2093342010
FaxNumber: 2093340132
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 02/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XA95138CAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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