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THEODORE E. STAAHL MD INC NPI 1467767541


NPI Information

NPI: 1467767541
Provider Name: THEODORE E. STAAHL MD INC

Other Name: MD LASER CENTER

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1329 SPANOS CT
SUITE A-1
MODESTO, CA
ZIP 95355
Phone: (209) 577-5700
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THEODORE E. STAAHL MD INC is a medical specialty clinic center in Modesto, CA. The provider is 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). THEODORE E. STAAHL MD INC NPI is 1467767541. The provider is registered as an organization entity type.
The provider Other Name Is Md Laser Center.

The provider's business location address is:

1329 SPANOS CT
SUITE A-1
MODESTO, CA
ZIP 95355-806
Phone: (209) 577-5700
Fax: (209) 577-5968

The provider's authorized official is Nancy Staahl .
The authorized official title is Administrator/office Manager and has the following contact phone number (209) 577-5700.

The enumeration date for this NPI number is 8/12/2010 and was last updated on 8/12/2010.


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
1261QM2500XClinic/CenterMedical SpecialtyG37452CALIFORNIAYes

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: 11/14/2023

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