YOSEMITE PATHOLOGY MEDICAL GROUP (NPI# 1831364140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831364140 |
| Entity Type | Organization |
| Organization Name | YOSEMITE PATHOLOGY MEDICAL GROUP |
| Practice Address |
1441 Florida Ave Modesto CA 95350-4405 |
| Mailing Address |
Po Box 576768 Modesto CA 95357-6768 |
| Practice Telephone | 2095771200 |
| Practice Fax Number | 2095776517 |
| Mailing Telephone | 2095771200 |
| Mailing Fax Number | 2095776517 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |
| Authorized Official Name | ROBERT COLLETTI (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 2095771200 |
| Authorized Official Credential | M.H.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | A72455 | CA | Laboratories |
| N | 291U00000X | Clinical Medical Laboratory | A83286 | CA | Laboratories |
| Y | 291U00000X | Clinical Medical Laboratory | G25623 | CA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0017740 | 05 |
| Street Address |
1441 FLORIDA AVE |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326044876 | Suhail Rahhal | Internal Medicine | 1441 Florida Ave, Modesto, CA 95350-4404 | 2005-06-21 |
| 1629603667 | Avinesh Prakash | Nurse Practitioner | 1441 Florida Ave, Modesto, CA 95350-4404 | 2020-03-10 |
| 1437784469 | Jose L Bazan | Nurse Practitioner | 1441 Florida Ave, Modesto, CA 95350-4404 | 2020-03-10 |
| 1770117541 | Sydney Edwards | Physician Assistant | 1441 Florida Ave, Modesto, CA 95350-4418 | 2020-03-02 |
| 1003466756 | Jessica Izelle Whipkey | Pharmacy Technician | 1441 Florida Ave, Modesto, CA 95350-4418 | 2019-09-16 |
| 1538715040 | Antoinette Marie Nguyen | Registered Nurse | 1441 Florida Ave, Modesto, CA 95350-4404 | 2019-08-12 |
| 1588229637 | Janel Mark | Perfusionist | 1441 Florida Ave, Modesto, CA 95350-4404 | 2019-05-03 |
| 1437713799 | Kunal Panwar | Student in an Organized Health Care Education/Training Program | 1441 Florida Ave, Modesto, CA 95350-4404 | 2019-04-23 |
| 1275196099 | Billy Huynh | Student in an Organized Health Care Education/Training Program | 1441 Florida Ave, Modesto, CA 95350-4418 | 2019-04-17 |
| 1063075067 | Herbert Mao | Student in an Organized Health Care Education/Training Program | 1441 Florida Ave, Modesto, CA 95350-4404 | 2019-04-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952849499 | Ez Sleep Club, Inc. | Clinical Medical Laboratory | 5039 Pentecost Dr Ste D, Modesto, CA 95356-9290 | 2017-02-04 |
| 1932248465 | Unilab Corporation | Clinical Medical Laboratory | 1401 Spanos Crt, Ste 107b, Modesto, CA 95355-2812 | 2007-02-05 |
| 1528095015 | Doctors Medical Center | Clinical Medical Laboratory | 730 Mchenry Avenue, Modesto, CA 95350-5413 | 2006-06-28 |
| 1629059746 | Sutter Central Valley Hospitals | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2005-11-07 |
| 1770943276 | Sutter Central Valley Hospitals | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2016-02-26 |
| 1285009035 | Sutter Valley Medical Foundation | Clinical Medical Laboratory | 600 Coffee Rd, Modesto, CA 95355-4201 | 2015-12-04 |
| 1639492317 | County of Stanislaus | Clinical Medical Laboratory | 820 Scenic Dr, Modesto, CA 95350-6131 | 2010-03-09 |
| 1881830040 | Valley Interventional Pain Medical Grp | Clinical Medical Laboratory | 1524 Mchenry Ave, #445, Modesto, CA 95350 | 2008-12-18 |
| 1285886515 | Sutter Gould Medical Foundation | Clinical Medical Laboratory | 600 Coffee Rd, Modesto, CA 95355-4201 | 2008-10-17 |
| 1750556718 | Yosemite Pathology Medical Group, Inc | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2008-04-29 |
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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.