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Organization
MODESTO ORTHOPEDIC MEDICAL GROUP
Active
Organization
MODESTO ORTHOPEDIC MEDICAL GROUP
Active
Other names
MODESTO ORTHOPEDIC GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MILAM (OFFICE MANAGER)
(209) 571-5071
Entity
Organization
Contact information
Practice address
1501 OAKDALE RD STE 301, MODESTO, CA 95355-3382
(209) 571-5071
(209) 577-1157
Mailing address
PO BOX 576158, MODESTO, CA 95357-6158
(209) 571-5071
(209) 577-1157
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/16/2017
Last updated
03/17/2018
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