Providence Family Practice Medical Group
Providence Family Practice Medical Group provides Family Medicine Physician services in Modesto, California. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
1213 Coffee Rd Ste BModesto, CA 95355-4229
Phone: (209) 491-2500
Fax: (209) 491-2545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|
Record details
| NPI number | 1104979582 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Kathie Cronin — Managing Partner · (209) 491-2500 |
| NPI enumerated | January 19, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 1213 Coffee Rd, Suite B, Modesto, CA 95355-4229 |
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