Healthcare Provider Details

I. General information

NPI: 1013794890
Provider Name (Legal Business Name): SATELLITE HEALTHCARE MODESTO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 04/29/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COFFEE RD STE 21
MODESTO CA
95355-1315
US

IV. Provider business mailing address

5851 LEGACY CIR STE 900
PLANO TX
75024-5982
US

V. Phone/Fax

Practice location:
  • Phone: 209-578-0691
  • Fax: 209-578-4479
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS L WEINBERG
Title or Position: CHAIRMAN & PRESIDENT
Credential:
Phone: 214-736-2700