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Organization
ESCALON PHYSICAL MEDICINE, INC
Active
Organization
ESCALON PHYSICAL MEDICINE, INC
Active
Other names
Modesto Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BYSTROM MD (OWNER)
(209) 838-3434
Entity
Organization
Contact information
Practice address
1933 COFFEE RD, MODESTO, CA 95355-2704
(209) 838-3434
(209) 838-7753
Mailing address
1933 COFFEE RD, MODESTO, CA 95355-2704
(209) 838-3434
(209) 838-7753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
A74921
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
04/07/2014
Last updated
01/11/2023
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