Individual
MR. MARK ANTHONY GOMES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N 9TH ST STE D, MODESTO, CA 95350-5814
(209) 552-2754
Mailing address
500 N 9TH ST, MODESTO, CA 95350-5814
(209) 552-2754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/29/2014
Last updated
06/17/2025
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