Organization
PACIFIC HOUSECALLS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK O'SULLIVAN PT (ADMINISTRATOR)
(209) 524-8700
Entity
Organization
Contact information
Practice address
3340 TULLY RD, SUITE C8A, MODESTO, CA 95350-0838
(209) 524-8700
(209) 846-7518
Mailing address
3340 TULLY RD, SUITE C8A, MODESTO, CA 95350-0838
(209) 524-8700
(209) 846-7518
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/31/2010
Last updated
03/22/2011
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