Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Modesto Dermatology and Skin Cancer PC

Organization Dermatology Physician · NPI 1093079485

Modesto Dermatology and Skin Cancer PC provides Dermatology Physician services in Modesto, California. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3105 McHenry Ave
Modesto, CA 95350-1439 Not confirmed with CMS for 14 years — call before visiting
Phone: (209) 575-2700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1093079485
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daniel Taheri — President · (209) 575-2700
NPI enumeratedJune 29, 2012
Last updated in NPPESJune 29, 2012
Mailing addressPo Box 496084, Redding, CA 96049-6084

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