MODESTO RADIOLOGICAL MEDICAL GROUP, INC


Address: 8673 Julie Lynne Cir, Tracy, CA 95304-9207
Phone: 2093425946

MODESTO RADIOLOGICAL MEDICAL GROUP, INC (NPI# 1134670656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134670656
Entity Type Organization
Organization Name MODESTO RADIOLOGICAL MEDICAL GROUP, INC
Practice Address 8673 Julie Lynne Cir
Tracy
CA 95304-9207
Mailing Address Po Box 7326
San Francisco
CA 94120-7326
Practice Telephone 2093425946
Mailing Telephone 5594554009
Mailing Fax Number 9165330313
Enumeration Date 2016-10-19
Last Update Date 2017-01-06
Authorized Official Name MARK E MOORE (COO)
Authorized Official Telephone 2093425946
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
Allopathic & Osteopathic Physicians

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1255872552 Modesto Radiological Medical Group, Inc Radiology 3421 Deep Waters Ct, Simi Valley, CA 93065-0587 2017-03-20
1073969838 Modesto Radiological Medical Group, Inc Radiology 148 Beachview Ave, Santa Cruz, CA 95060-3008 2016-05-11
1992170542 Modesto Radiological Medical Group, Inc Radiology 728 Murphy Dr, San Mateo, CA 94402-3421 2015-12-08
1023482296 Modesto Radiological Medical Group, Inc Radiology 6729 Monte Rd, San Luis Obispo, CA 93401-8050 2015-11-25
1861866022 Modesto Radiological Medical Group, Inc Radiology 1648 Dalton Rd, Palos Verdes Estates, CA 90274-1835 2015-11-25
1760856934 Modesto Radiological Medical Group, Inc Radiology 2132 Lysander Way, Roseville, CA 95661-3220 2015-11-25
1154808095 Modesto Radiological Medical Group, Inc Radiology 3750 Whitman Cir, Carmel, CA 93923-8326 2018-07-24
1881198604 Modesto Radiological Medical Group, Inc Radiology 1202 Chelshurst Way, Spring, TX 77379-3247 2018-03-19
1063953362 Modesto Radiological Medical Group, Inc Radiology 1200 4th St, Apt 103, San Francisco, CA 94158-2392 2017-03-20
1265973556 Modesto Radiological Medical Group, Inc Radiology 6043 E Birdcage Ct, Orange, CA 92869-6015 2017-03-20

Office Location

Street Address 8673 JULIE LYNNE CIR
City TRACY
State CA
Zip Code 95304-9207

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770934226 Tracy Dental Excellence, Chase Dental Group, Inc. Dentist 2858 West Grantline Rd, Tracy, CA 95304 2016-06-27
1396153474 Reny Matthew Pharmacist 3010 W Grantline Road, Tracy, CA 95304 2014-08-01
1023286879 Maneeza A Kulaly Dentist 2616 Pavilion Pkwy, Suite B, Tracy, CA 95304 2008-02-14
1447437892 Norma Jean Paisley Social Worker 30000 Kasson Rd. #323, Tracy, CA 95304 2008-01-29
1811061641 Katherine D Sanchez Dds Inc Dentist 2643 Naglee Rd, Tracy, CA 95304 2006-11-20
1851401467 Costco Wholesale Corporation Pharmacy 3250 W Grant Line Rd, Tracy, CA 95304 2006-08-30
1942218128 Adarsh Kaur Dentist 23500, Kasson Road, Tracy, CA 95304 2006-08-04
1982078630 Janet Joanne Graham Licensed Practical Nurse 23500 Kasson Road, Tracy, CA 95304 2015-11-18
1215277207 Dawn Bramley Psychologist 23500 Kasson Rd, Tracy, CA 95304 2013-02-27
1760670509 Franklin Rafanan Social Worker 23500 Kasson Road, Tracy, CA 95304 2007-10-05
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619948882 Saral K Verma Radiology 443 W Eaton Ave, Tracy, CA 95376 2006-01-27
1063444768 Mario P Sattah Radiology 1530 Bessie Ave, Suite 108, Tracy, CA 95376 2006-07-06
1669430518 Robert M Lim Radiology 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 2006-05-02
1750341483 Joseph Marshall Radiology 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 2006-03-25
1154312668 Chull Sung Song Radiology 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 2005-11-03
1275523151 Advanced Imaging of Tracy LLC Radiology 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 2005-10-24
1194715078 Garth Howland Harley Jr. Radiology 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 2005-10-24
1053301945 Richard Michael Porzio Radiology 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 2005-10-24
1407846264 Kyle Kai Yu Radiology 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 2005-10-24
1578553335 Sam Peter Kokoris Radiology 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 2005-10-24
Find all providers in TRACY

Competitor

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City TRACY
Zip Code 95304

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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