| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1174119598 | LUO | KERY | 1205 E NORTH ST | MANTECA | CA | 953364932 | ||
| 1811023138 | MARCONI | KATY | MAREE | 1205 E NORTH ST | MANTECA | CA | 953364932 | |
| 1548600224 | PANDAMOUZ | ALI | 1205 E NORTH ST | MANTECA | CA | 953364932 |