Healthcare Provider Details

I. General information

NPI: 1366323032
Provider Name (Legal Business Name): SLOOTSKY PHYSICAL MEDICINE & REHABILITATION, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 MABLE AVE
MODESTO CA
95355-1119
US

IV. Provider business mailing address

2365 LE CONTE AVE APT B
BERKELEY CA
94709-1360
US

V. Phone/Fax

Practice location:
  • Phone: 209-857-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: BRYAN SLOOTSKY
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 561-702-4012