Individual
ALBERT K.Q. SIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2625 COFFEE RD, STE S, MODESTO, CA 95355-2050
(209) 577-1200
(209) 577-6517
Mailing address
2625 COFFEE RD, STE S, MODESTO, CA 95355-2050
(209) 577-1200
(209) 577-6517
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
C42209
CA
207ZC0500X
Cytopathology Physician
C42209
CA
207ZD0900X
Dermatopathology (Pathology) Physician
C42209
CA
207ZH0000X
Hematology (Pathology) Physician
C42209
CA
207ZI0100X
Immunopathology Physician
C42209
CA
207ZM0300X
Medical Microbiology Physician
C42209
CA
207ZN0500X
Neuropathology Physician
C42209
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C42209
CA
207ZP0104X
Chemical Pathology Physician
C42209
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
C42209
CA
207ZP0213X
Pediatric Pathology Physician
C42209
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220020692
RAILROAD MEDICARE NO
CA
01
—
BO964
MEDICARE PTAN
CA
05
—
LAB09388F
—
CA
Enumeration date
03/09/2006
Last updated
11/23/2016
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