Organization
MODERN NEUROCARE MEDICAL CENTER
Active
Organization
MODERN NEUROCARE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADAN PRASAD MD (PRESIDENT/CEO)
(209) 951-8830
Entity
Organization
Contact information
Practice address
1801 E MARCH LN, SUITE B-220, STOCKTON, CA 95210-6629
(209) 951-8830
(209) 951-8831
Mailing address
PO BOX 7393, STOCKTON, CA 95267-0393
(209) 951-8830
(209) 951-8831
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A86600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A866000
—
CA
Enumeration date
07/18/2006
Last updated
12/07/2018
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