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Individual

DR. ELMER PEDERE IGNACIO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1524 MCHENRY AVE., STE. 450, MODESTO, CA 95350
(209) 557-6201
Mailing address
2700 REMBRANDT PL, MODESTO, CA 95356-0349
(209) 521-5731

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A42103
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3427319
CA
Enumeration date
06/16/2006
Last updated
07/08/2007
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