Organization
TRACY BIGELOW, DO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L BIGELOW DO (OWNER)
(209) 524-4649
Entity
Organization
Contact information
Practice address
1335 COFFEE RD, STE 100, MODESTO, CA 95355-3188
(209) 524-4649
(209) 524-7395
Mailing address
1335 COFFEE RD, STE 100, MODESTO, CA 95355-3188
(209) 524-4649
(209) 524-7395
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
20A11567
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A 11567
CALIFORNIA OSTEOPATHIC MEDICAL LICENSE
CA
Enumeration date
02/28/2011
Last updated
01/07/2013
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