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

Specialty Medical Group Central California - Dept of Modesto

Organization Pediatrics Physician · NPI 1083858492

Specialty Medical Group Central California - Dept of Modesto provides Pediatrics Physician services in Modesto, California. Licensed in California. Registered with an NPI since 2009.

Licensed in
CA
In the registry since
2009
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Practice location Address checks out

1524 McHenry Ave 570
Modesto, CA 95350-4500 Not confirmed with CMS for 13 years — call before visiting
Phone: (209) 572-3880
Fax: (209) 572-3349
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X (CA)

Record details

NPI number1083858492
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSpecialty Medical Group Central California, Inc
Authorized official Devonna Kaji — President/Medical Director · (559) 353-5700
NPI enumeratedApril 29, 2009
Last updated in NPPESJune 28, 2013
Mailing address9300 Valley Childrens Pl, Madera, CA 93636-8761

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