Individual
JOHN D FICHTENKORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
G57591
CA
2083X0100X
Occupational Medicine Physician
G57591
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G575910
—
CA
Enumeration date
10/31/2007
Last updated
01/06/2009
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