Healthcare Provider Details

I. General information

NPI: 1093381253
Provider Name (Legal Business Name): DALE ROGER MORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 FLORIDA AVE
MODESTO CA
95350-4404
US

IV. Provider business mailing address

PO BOX 206
HILMAR CA
95324-0206
US

V. Phone/Fax

Practice location:
  • Phone: 209-578-1211
  • Fax: 209-729-4008
Mailing address:
  • Phone: 530-219-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA198910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: