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Organization
HOSPITALISTS OF MODESTO MEDICAL GROUP INC
Active
Organization
HOSPITALISTS OF MODESTO MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M WALLACE M.D. (CEO)
(209) 576-3525
Entity
Organization
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 576-3525
(209) 729-4008
Mailing address
1700 MCHENRY AVENUE, STE 65B #259, MODESTO, CA 95350-4333
(209) 576-3525
(209) 576-3544
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G42269
CA
Other
Enumeration date
09/02/2006
Last updated
08/04/2025
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