Organization
MCHENRY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRIS MICHAEL GOODMAN M.D. (CHAIR)
(209) 577-3388
Entity
Organization
Contact information
Practice address
1000 DELBON AVE, SUITE 2, TURLOCK, CA 95382-2008
(209) 634-8556
Mailing address
1541 FLORIDA AVE, SUITE 200, MODESTO, CA 95350-4429
(209) 577-3388
(209) 342-3743
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ48224Z
MEDICARE
CA
Enumeration date
01/17/2008
Last updated
01/17/2008
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