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Individual

ANTHONY REX VICTORIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
A86106
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A86106
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A86106
LICENSE
CA
Enumeration date
05/02/2007
Last updated
02/01/2021
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