CENTRAL VALLEY FUNCTIONAL RESTORATION PROGRAM NPI 1467992412

NPI Information

NPI: 1467992412
Provider Name: CENTRAL VALLEY FUNCTIONAL RESTORATION PROGRAM
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 05D2096622

Address:
2004 MCHENRY AVE
STE C
MODESTO, CA
ZIP 95350
Phone: (209) 337-3377
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CENTRAL VALLEY FUNCTIONAL RESTORATION PROGRAM is a multi-specialty clinic center in Modesto, CA. CENTRAL VALLEY FUNCTIONAL RESTORATION PROGRAM NPI is 1467992412. The provider is registered as an organization entity type.

The provider's business location address is:

2004 MCHENRY AVE
STE C
MODESTO, CA
ZIP 95350-260
Phone: (209) 337-3377
Fax: (209) 729-5353

The provider's authorized official is Robert Caton .
The authorized official title is President and has the following contact phone number (209) 491-5370.

The CLIA number assigned to this NPI record is 05D2096622 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/24/2017 and was last updated on 2/24/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty		CALIFORNIA	Yes

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

NPI Synchronization or Removal

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