Modica, Jesse Russell
Modica, Jesse Russell is an individual health care provider with primary practice located at 165 N Redwood Dr Suite 120, San Rafael CA 94903-1969. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Modica, Jesse Russell can be contacted via phone (415) 499-0278.Contact Information
Primary practice address
165 N Redwood Dr Suite 120
San Rafael CA 94903-1969
Phone: (415) 499-0278
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 33875 | California |
Profile Details
| NPI number | 1700043221 |
|---|---|
| LBN Legal business name | Modica, Jesse Russell |
| Credentials | P.T., D.P.T., M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 21st, 2008 |
| Last updated | Apr 10th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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