Healthcare Provider Details

I. General information

NPI: 1124021035
Provider Name (Legal Business Name): CATHERINE A BIREN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 NELSON AVE STE B
MODESTO CA
95350-5341
US

IV. Provider business mailing address

1324 NELSON AVE STE B
MODESTO CA
95350-5341
US

V. Phone/Fax

Practice location:
  • Phone: 209-524-9481
  • Fax: 209-524-9486
Mailing address:
  • Phone: 209-524-9481
  • Fax: 209-524-9486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberGR0045780
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG48190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: