DR. CHESTER MCBRIDE BOLTWOOD JR.


Address: 4603 Dale Rd, Kaiser Permanente Medical Offices, Modesto, CA 95357-7680
Phone: 2097354287

DR. CHESTER MCBRIDE BOLTWOOD JR. (NPI# 1669415303) 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) 1669415303
Entity Type Individual
Full Name DR. CHESTER MCBRIDE BOLTWOOD JR.
Credential MD
Practice Address 4603 Dale Rd
Kaiser Permanente Medical Offices
Modesto
CA 95357-7680
Mailing Address 4601 Dale Rd
Modesto
CA 95357-7680
Practice Telephone 2097354287
Practice Fax Number 2097354283
Mailing Telephone 2097354287
Mailing Fax Number 2097354283
Enumeration Date 2006-06-13
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
G35042 CA Allopathic & Osteopathic Physicians
X 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
G35042 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA ZZZ76734Z 05

Office Location

Street Address 4603 DALE RD
KAISER PERMANENTE MEDICAL OFFICES
City MODESTO
State CA
Zip Code 95357-7680

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NPI Name Taxonomy Address Enumeration
1417280892 Brighter Futures Therapeutic Learning Center Occupational Therapist 4715 Yosemite Boulevard, Modesto, CA 95357 2009-09-16
1205976859 Jeffery R Anderson Chiropractor 3609 Oakdale Rd Ste 5, Modesto, CA 95357 2007-02-06
1881647360 Paul W Embree Surgery 4543 Roselle Av, Modesto, CA 95357 2006-05-18
1124664461 Michelle Sullivan Speech-Language Pathologist 4715 Yosemite Boulevard, Modesto, CA 95357 2019-11-21
1558691030 John William Hill Chiropractor 3609 Oakdale Rd, Modesto, CA 95357 2010-01-06
1538529938 Communication Station, Inc Speech-Language Pathologist 4605 Via Giardiano, Modesto, CA 95357-0661 2016-02-26
1801307491 Brittany H Vass Occupational Therapist 4605 Via Giardiano, Modesto, CA 95357-0661 2017-10-23
1487015202 Olga Christina De Leon Speech-Language Pathologist 4605 Via Giardiano, Modesto, CA 95357-0661 2016-03-08
1881239622 Christian Buck Registered Nurse 4605 Via Altura, Modesto, CA 95357-0667 2019-11-15
1134261050 Larry Cooper King Hearing Instrument Specialist 3520 Oakdale Rd. Ste. B, Modesto, CA 95357-0714 2007-02-14
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1972550150 Shewit K Weldetensae Internal Medicine 1540 Florida Ave 100, Modesto, CA 95350-4430 2006-05-31
1063469245 Satnam Singh Ludder Internal Medicine 1540 Florida Ave Ste 100, Modesto, CA 95350-4430 2006-05-31
1386615631 Walter W Chien Internal Medicine 2013 Coffee Rd, Modesto, CA 95355-2405 2006-01-26
1568445534 Isao Jack Tsuji Internal Medicine 1401 Spanos Court, Ste 230, Modesto, CA 95355-7813 2005-11-23
1144695958 Sutter Valley Medical Foundation Internal Medicine 1409 E Briggsmore Ave, Modesto, CA 95355-2707 2015-12-04
1164734489 Mutahir Ubaid Khan Internal Medicine 1401 Spanos Ct, Suite 230, Modesto, CA 95355-2810 2010-07-02
1134364334 Emad S Najjar Internal Medicine 1540 Florida Ave, Modesto, CA 95350-4430 2008-12-03
1174785695 Anant K Vyas Internal Medicine 1540 Florida Ave Ste 100, Modesto, CA 95350-4430 2008-06-26
1720292733 Western Associates In Surgery Internal Medicine 2209 Coffee Road, Suite M, Modesto, CA 95355 2007-05-09
1073680971 Navneet K. Dullet Internal Medicine 1540 Florida Ave Ste 100, Modesto, CA 95350-4430 2006-11-29
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Competitor

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City MODESTO
Zip Code 95357

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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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