Individual
JAMES GARETH MISSLBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G51378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G513780
—
CA
Enumeration date
05/08/2006
Last updated
03/21/2019
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