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ORANGEBURG MEDICAL GROUP NPI 1467595389


NPI Information

NPI: 1467595389
Provider Name: ORANGEBURG MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0964407

Address:
1448 FLORIDA AVE
MODESTO, CA
ZIP 95350
Phone: (209) 343-8126
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ORANGEBURG MEDICAL GROUP is a family medicine in Modesto, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ORANGEBURG MEDICAL GROUP NPI is 1467595389. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1448 FLORIDA AVE
MODESTO, CA
ZIP 95350-424
Phone: (209) 343-8126
Fax: (209) 523-2566

The provider's authorized official is Arthur Lee Hill .
The authorized official title is Administrator and has the following contact phone number (206) 343-8126.

The CLIA number assigned to this NPI record is 05D0964407 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes
2208600000XSurgeryX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0021000MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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