SURGICAL ASSOCIATES INC (NPI# 1366824161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366824161 |
| Entity Type | Organization |
| Organization Name | SURGICAL ASSOCIATES INC |
| Practice Address |
1700 Coffee Rd Modesto CA 95355-2803 |
| Mailing Address |
220 Standiford Ave Ste F Modesto CA 95350-1159 |
| Practice Telephone | 2096614403 |
| Practice Fax Number | 2095795637 |
| Mailing Telephone | 2095795628 |
| Mailing Fax Number | 2095795637 |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | TONY TAM (OWNER) |
| Authorized Official Telephone | 2096614403 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972677912 | Surgical Associates Inc | Surgery | 2226 Liliha St, Suite 402, Honolulu, HI 96817-1600 | 2006-11-20 |
| Street Address |
1700 COFFEE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629059746 | Sutter Central Valley Hospitals | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2005-11-07 |
| 1356962732 | Nicole Laura | Physical Therapist | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2020-04-27 |
| 1275153314 | Christopher Lucas | Pharmacist | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2020-04-18 |
| 1366077323 | Nicole Kathleen Boere | Nurse Practitioner | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2020-03-10 |
| 1235770165 | P. Curly Johnson | Nurse Practitioner | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2019-10-02 |
| 1932758596 | Samantha Megan Allen | Nurse Practitioner | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2019-09-06 |
| 1215592324 | Brittany Henson | Physical Therapist | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2019-05-03 |
| 1306317987 | Jacob John Verhoeven | Physician Assistant | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2018-12-08 |
| 1164992277 | Jessica Chan | Physician Assistant | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2018-12-01 |
| 1851875397 | John Paul Blanchard | Nurse Practitioner | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2018-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275573446 | Antonio Kobyashi Coirin | Surgery | 1552 Coffee Rd Ste 200, Modesto, CA 95355-3122 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558809277 | Southern California Hepatobiliary Pancreatic and Robotic Surgery Ins | Surgery | 5805 Sepulveda Blvd Ste 690, Sherman Oaks, CA 91411 | 2017-02-01 |
| 1609212919 | Daniel Eldridge Smith | Surgery | 11175 Campus St # 21111, Loma Linda, CA 92350 | 2013-05-14 |
| 1841553187 | Ning Lu | Surgery | 9898 Genesee Ave Fl 1, La Jolla, CA 92037-1205 | 2012-06-21 |
| 1942588868 | Trauma & Critical Care Sfv Group Inc | Surgery | 11550 Indian Hills Road, Suite 310, Mission Hills, CA 91345 | 2011-07-26 |
| 1467652859 | Trauma Vascular Surgeons Inc | Surgery | 12400 Ventura Blvd # 374, Studio City, CA 91604-2406 | 2007-07-23 |
| 1194819532 | North County Trauma Services, Inc. | Surgery | 451 March Avenue, Suite B, Healdsburg, CA 95448-3387 | 2006-10-02 |
| 1598863193 | Lawrence Roberts | Surgery | 7930 Frost St Ste 204, San Diego, CA 92123-2739 | 2006-09-20 |
| 1467563791 | North County Trauma Associates, Inc. A Medical Group | Surgery | 215 South Hickory Avenue, Suite 112, Escondido, CA 92025-4360 | 2006-08-31 |
| 1922116987 | Dinh Nhatton Nguyen | Surgery | 1800 Harrison St Fl 7, Oakland, CA 94612-3466 | 2006-08-29 |
| 1477564474 | Todd A Kanen | Surgery | 5333 Hollister Ave Ste 210, Santa Barbara, CA 93111-3331 | 2006-08-11 |
| Find all providers with the same taxonomy | ||||
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| 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.