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General NPI Number Information
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NPI Number | 1356209605
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Entity Type | Organization
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Legal Business Name | BRIAN J CORMIER PHYSICIAN ASSISTANT INC
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 1878 E HATCH RD
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City | MODESTO
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State | CA
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Zip | 95351-5002
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Country | US
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Telephone | 209-845-2553
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Fax | 209-844-0334
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Provider Business Mailing Address
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Address Line | PO BOX 576649
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City | MODESTO
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State | CA
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Zip | 95357-6649
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Country | US
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Telephone | 209-845-2553
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Fax | 209-845-2553
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | BRIAN J CORMIER
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Credential | PA
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Telephone | 209-605-4966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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