# SUMMIT SURGERY CENTER MODESTO, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619525912
- **Authorized official:** DR. RAJESH KUMAR DUBEY MD (MANAGING PARTNER)
- **Authorized official phone:** (209) 918-5181

## Contact information

- **Practice address:** 654 LYELL DR, MODESTO, CA 95356-8997
- **Practice address phone:** (209) 521-9661
- **Practice address fax:** (209) 521-2640
- **Mailing address:** 3621 FOREST GLENN DR, MODESTO, CA 95355-1339
- **Mailing address phone:** (209) 521-9661
- **Mailing address fax:** (209) 521-2640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/29/2019
- **Last updated:** 02/28/2020