Healthcare Provider Details

I. General information

NPI: 1558657106
Provider Name (Legal Business Name): CHRISTINE LOUISE BATTAGLIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DELBON AVE
TURLOCK CA
95382-2022
US

IV. Provider business mailing address

PO BOX 577197
MODESTO CA
95357-7197
US

V. Phone/Fax

Practice location:
  • Phone: 209-850-3500
  • Fax: 209-558-5036
Mailing address:
  • Phone: 209-605-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A12492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: