Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MCHENRY MEDICAL GROUP INC
Active
Organization
MCHENRY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRIS MICHAEL GOODMAN MD (CHAIR EXECUTIVE COMMITTEE)
(209) 577-3388
Entity
Organization
Contact information
Practice address
1541 FLORIDA AVENUE, SUITE 200, MODESTO, CA 95350
(209) 577-3388
(209) 342-3743
Mailing address
1541 FLORIDA AVENUE, SUITE 200, MODESTO, CA 95350
(209) 577-3388
(209) 342-3743
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ48224Z
MEDICARE #
CA
Enumeration date
07/25/2006
Last updated
01/18/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up