THEODORE E. STAAHL MD INC (NPI# 1467767541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467767541 |
| Entity Type | Organization |
| Organization Name | THEODORE E. STAAHL MD INC |
| Other Organization Name | MD LASER CENTER |
| Practice Address |
1329 Spanos Ct Suite A-1 Modesto CA 95355-2806 |
| Practice Telephone | 2095775700 |
| Practice Fax Number | 2095775968 |
| Mailing Telephone | 2095775700 |
| Mailing Fax Number | 2095775968 |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |
| Authorized Official Name | MRS. NANCY STAAHL (ADMINISTRATOR/OFFICE MANAGER) |
| Authorized Official Telephone | 2095775700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
G37452 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MD Laser Center | Other Name - Individual/Organization |
| Street Address |
1329 SPANOS CT SUITE A-1 |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-2806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851406581 | Drew H. Logue, M.d., Inc. | Specialist | 1329 Spanos Ct, Suite C-3, Modesto, CA 95355-2806 | 2006-08-21 |
| 1184084980 | Karen Michelle Barbe | Physician Assistant | 1329 Spanos Ct, Suite B4, Modesto, CA 95355-2806 | 2016-03-07 |
| 1679696660 | Antonio K Coirin M.d. Inc. | Specialist | 1329 Spanos Ct, Siute B4, Modesto, CA 95355-2806 | 2007-04-06 |
| 1881649838 | Sutter Gould Medical Foundation | Family Medicine | 1329 Spanos Ct, #b-4, Modesto, CA 95355-2806 | 2006-05-24 |
| 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 | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003449703 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 3105 Mchenry Ave Ste 101, Modesto, CA 95350-1439 | 2020-02-20 |
| 1306039706 | Alexander A Davis, Md Inc | Clinic/Center | 1401 Spanos Court, Suite 101, Modesto, CA 95355-2812 | 2007-08-20 |
| 1396954921 | Jackie T. Chan, M.d., Inc. | Clinic/Center | 809 Sylvan Ave, Suite 400, Modesto, CA 95350-1500 | 2007-05-21 |
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| 1003440884 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 300 Old River Rd Ste 120, Bakersfield, CA 93311-9512 | 2020-03-02 |
| 1083247795 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 1025 N Demaree St, Visalia, CA 93291-4117 | 2020-02-20 |
| 1780217489 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 621 W Line St Ste 105, Bishop, CA 93514-3320 | 2020-02-20 |
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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.