Genicoff, Alan

Genicoff, Alan is an individual health care provider with primary practice located at 525 West Acacia Street , Stockton CA 95203-2405. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Emergency Medical Service Providers / Personal Emergency Response Attendant. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Genicoff, Alan can be contacted via phone (209) 944-5550.

Contact Information

Primary practice address
525 West Acacia Street Stockton CA 95203-2405
Phone: (209) 944-5550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X G86130 California
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X G86130 California

Profile Details

NPI number 1558370551
LBN Legal business name Genicoff, Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated May 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558370551 NPPES
California MEDICAID 00G861300

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