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General NPI Number Information
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NPI Number | 1184654923
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Entity Type | Organization
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Legal Business Name | DOCTORS MEDICAL CENTER OF MODESTO, INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1441 FLORIDA AVE
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City | MODESTO
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State | CA
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Zip | 95350-4405
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Country | US
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Telephone | 209-578-1211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57376
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City | LOS ANGELES
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State | CA
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Zip | 90074-7376
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Country | US
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Telephone | 209-578-2513
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Fax | 209-576-3680
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Authorized Official
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Title or Position | CFO
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Name | BRANDON GARDNER
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Credential |
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Telephone | 209-576-3790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 030000026
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License Number State | CA
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