Healthcare Provider Details

I. General information

NPI: 1912188053
Provider Name (Legal Business Name): SEBNEM OZDOGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 PELANDALE AVE
MODESTO CA
95356-9781
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 209-572-3880
  • Fax: 209-572-3349
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number33328
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberA94693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: