Healthcare Provider Details

I. General information

NPI: 1164363024
Provider Name (Legal Business Name): AMERICAN SPECIALTY PHYSICIANS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 17TH ST STE 205
MODESTO CA
95354-1249
US

IV. Provider business mailing address

240 SPRUCE ST
GRIDLEY CA
95948-2216
US

V. Phone/Fax

Practice location:
  • Phone: 877-346-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY JEAN THOMPSON
Title or Position: VP OF FINANCE
Credential:
Phone: 209-287-6308