MED-1 MEDICAL CENTER PROFESSIONAL CORPORATION NPI 1275691339

NPI Information

MED-1 MEDICAL CENTER PROFESSIONAL CORPORATION is a corporate health clinic center in Modesto, CA. MED-1 MEDICAL CENTER PROFESSIONAL CORPORATION NPI is 1275691339. The provider is registered as an organization entity type.

The provider's business location address is:

3508 DALE RD
MODESTO, CA
ZIP 95356-552
Phone: (209) 574-1355
Fax: (209) 571-8204

The provider's authorized official is Alan Russakov .
The authorized official title is President and has the following contact phone number (290) 574-1355.

The enumeration date for this NPI number is 12/4/2006 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:

Other Identifiers

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