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General NPI Number Information
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NPI Number | 1861832008
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Entity Type | Organization
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Legal Business Name | JOSHUA R. MODLIN DPM
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 5400 ALDRIN CT
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City | BAKERSFIELD
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State | CA
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Zip | 93313-2103
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Country | US
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Telephone | 661-800-1924
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Fax | 661-833-0500
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Provider Business Mailing Address
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Address Line | 7850 WHITE LN STE E116
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7698
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Country | US
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Telephone | 661-800-1924
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Fax | 661-833-0500
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Authorized Official
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Title or Position | DOCTOR
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Name | JOSHUA R MODLIN
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Credential | DPM
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Telephone | 661-836-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4960
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License Number State | CA
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