Modesto Neonatal Medical Group, Inc.

LBN: Modesto Neonatal Medical Group, Inc.
Modesto Neonatal Medical Group, Inc. is an health care organization with primary practice located at 1441 Florida Ave , Modesto CA 95350-4405. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as the primary health care specialty. Modesto Neonatal Medical Group, Inc. can be contacted via phone (209) 571-8330, or through Wallace, Gina via phone (209) 571-8330.

Contact Information

Primary practice address
1441 Florida Ave Modesto CA 95350-4405
Phone: (209) 571-8330
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Gina
Phone: (209) 571-8330

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 39491 California

Profile Details

NPI number 1912197294
LBN Legal business name Modesto Neonatal Medical Group, Inc.
DBA Doing business as
Authorized official Wallace, Gina
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2007
Last updated Aug 1st, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912197294 NPPES
California Other ZZZ39491Z BLUE SHIELD
California MEDICAID GR0090580 BLUE SHIELD

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