| Modesto Office | |
|
1729 Tully Rd Number 3 Modesto CA 95350-4082 | |
| (209) 892-1300 | |
| (209) 780-4141 |
| Full Name | Modesto Office |
|---|---|
| Speciality | Family Medicine |
| Location | 1729 Tully Rd, Modesto, California |
| Authorized Official Name and Position | Ali Abdul Wahid (PRESIDENT) |
| Authorized Official Contact | 2098921300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modesto Office 1729 Tully Rd Suite 3 Modesto CA 95350-4082 Ph: (209) 892-1300 | Modesto Office 1729 Tully Rd Number 3 Modesto CA 95350-4082 Ph: (209) 892-1300 |
| NPI Number | 1881098606 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881098606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A106703 (California) | Primary |
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