Organization
MADHURI KAMATHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LUCY PIRES (ADMINISTRATIVE ASST)
(209) 576-3525
Entity
Organization
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 576-3525
(209) 576-3544
Mailing address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 576-3525
(209) 576-3544
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
A97936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A97936
MEDICAL LICENSE
CA
Enumeration date
05/16/2007
Last updated
07/07/2008
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