# DOCTORS MEDICAL CENTER OF MODESTO, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Doctors Medical Center of Modesto
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215189782
- **Authorized official:** DR. RONALD KAUFMAN (REGIONAL CMO; TENET)
- **Authorized official phone:** (714) 428-6812

## Contact information

- **Practice address:** 1441 FLORIDA AVE, MODESTO, CA 95350-4405
- **Practice address phone:** (209) 578-1211
- **Mailing address:** 3125 CONANT AVE, MODESTO, CA 95350-6527
- **Mailing address phone:** (209) 573-6103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 2086S0127X | Trauma Surgery Physician | — | NULL | — |
| 2086S0127X | Trauma Surgery Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 10/16/2008
- **Last updated:** 05/26/2016