MEDICARE: MODERN ORTHOPEDICS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	A147622	CA

General Provider Information

NPI Number	:	1356828628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN ORTHOPEDICS PC

Provider Business Mailing Address
First Line	:	PO BOX 321207
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-0120
Country	:	US
Telephone Number	:	408-356-4959
Fax Number	:	408-358-8692

Provider Business Practice Location Address
First Line	:	800 POLLARD RD STE C30
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-1431
Country	:	US
Telephone Number	:	408-353-0203
Fax Number	:	408-353-0204

Authorized Official
Title or Position	:	DOCTOR/ OWNER
Name	:	DR. IAN J BARRETT
Credential	:	MD
Telephone Number	:	201-741-3431

Provider Enumeration Date	:	07/19/2018
Last Update Date	:	04/11/2023

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Directions to “MODERN ORTHOPEDICS PC ” Practice Location

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