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MODESTO RADIOLOGICAL MEDICAL GROUP INC NPI 1881198604


NPI Information

NPI: 1881198604
Provider Name: MODESTO RADIOLOGICAL MEDICAL GROUP, INC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 05D2037380

Address:
1202 CHELSHURST WAY
SPRING, TX
ZIP 77379
Phone: (559) 455-4009
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MODESTO RADIOLOGICAL MEDICAL GROUP, INC is a diagnostic radiology radiology in Spring, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MODESTO RADIOLOGICAL MEDICAL GROUP, INC NPI is 1881198604. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1202 CHELSHURST WAY
SPRING, TX
ZIP 77379-247
Phone: (559) 455-4009

The provider's authorized official is Mark E Moore .
The authorized official title is Cfo and has the following contact phone number (209) 577-4444.

The CLIA number assigned to this NPI record is 05D2037380 - other - idtf with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/19/2018 and was last updated on 3/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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