| Modern Neurocare Medical Center | |
|
1801 E March Ln Suite B-220 Stockton CA 95210-6629 | |
| (209) 951-8830 | |
| (209) 951-8831 |
| Full Name | Modern Neurocare Medical Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1801 E March Ln, Stockton, California |
| Authorized Official Name and Position | Madan Prasad (PRESIDENT/CEO) |
| Authorized Official Contact | 2099518830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Neurocare Medical Center Po Box 7393 Stockton CA 95267-0393 Ph: (209) 951-8830 | Modern Neurocare Medical Center 1801 E March Ln Suite B-220 Stockton CA 95210-6629 Ph: (209) 951-8830 |
| NPI Number | 1366461782 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 12/07/2018 |
| Medicare PECOS PAC ID | 0446238026 |
|---|---|
| Medicare Enrollment ID | O20040709001192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366461782 | NPI | - | NPPES |
| 00A866000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A86600 (California) | Primary |
| Provider Name | Madan Prasad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639198054 PECOS PAC ID: 9133101728 Enrollment ID: I20040709001249 |
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