Unknown Individual – Internal Medicine Physician, NPI 1669428728
Internal Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
600, Coffee Road, Modesto, Stanislaus County, California, 95355, United States
MODESTO, CA 953554201
Phone: (209) 521-6097
Fax: (209) 521-4081
Type: Mailing
2505, West Hammer Lane, Stockton, San Joaquin County, California, 95209, United States
STOCKTON, CA 952092839
Phone: (209) 957-7050
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95355)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MT | |
| - | ID | |
| - | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| Orthopedic Surgery | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| - | CA |
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