Organization
GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R PORTEOUS M.D. (PRESIDENT)
(209) 577-3388
Entity
Organization
Contact information
Practice address
1262 E NORTH ST, SUITE B, MANTECA, CA 95336-4962
(209) 214-7053
(209) 523-0764
Mailing address
1541 FLORIDA AVE, SUITE 200, MODESTO, CA 95350-4423
(209) 577-3388
(209) 523-0764
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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