Organization
NINEVEH OUTREACH
Active
Parent organization
CALVARY TEMPLE WORSHIP CENTER
Other names
Hope Medivan
Organization subpart
Yes
Provider details
NPI number
Legal business name
CALVARY TEMPLE WORSHIP CENTER
Authorized official
DR. MANUEL L CANGA M.D. (MEDICAL DIRECTOR)
(209) 529-7346
Entity
Organization
Contact information
Practice address
1601 COFFEE RD, MODESTO, CA 95355-2801
(209) 529-7346
(209) 529-7034
Mailing address
PO BOX 578901, MODESTO, CA 95357-8901
(209) 529-7346
(209) 529-7034
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
550001116
CA
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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