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General NPI Number Information
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NPI Number | 1689066029
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST MEDICAL CARE A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1317 OAKDALE RD STE 440
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City | MODESTO
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State | CA
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Zip | 95355-3364
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Country | US
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Telephone | 209-522-3362
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Fax | 209-522-3363
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Provider Business Mailing Address
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Address Line | 1317 OAKDALE RD SUITE 440
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City | MODESTO
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State | CA
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Zip | 95355-3361
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Country | US
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Telephone | 209-522-3362
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Fax | 209-522-3363
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Authorized Official
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Title or Position | PRINCIPLE OFFICER
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Name | SILVIA M DIEGO
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Credential | M.D.
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Telephone | 209-522-3362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | CA
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