Basic Information
| Provider Information | |||||||||
| NPI: | 1669849394 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY & CRITICAL CARE ASSOCIATES OF MODESTO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4008 PICKFORD WAY | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953569347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095795628 | ||||||||
| FaxNumber: | 2095795637 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 FLORIDA AVE | ||||||||
| Address2: | HOSPITALIST OFFICE | ||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953504404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095763525 | ||||||||
| FaxNumber: | 2094763544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2015 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | RAMANJEET | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2096061181 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | A124976 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.