Organization
MCHENRY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MEDEIROS (BUSINESS OFFICE SUPERVISOR)
(209) 576-2900
Entity
Organization
Contact information
Practice address
1524 MCHENRY AVE, SUITE 240, MODESTO, CA 95350-4500
(209) 576-2900
(209) 576-7319
Mailing address
1524 MCHENRY AVE, SUITE 240, MODESTO, CA 95350-4500
(209) 576-2900
(209) 576-7319
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR01026G
—
CA
Enumeration date
06/21/2006
Last updated
08/22/2020
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