Organization
GARY J PADOVANI MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY J PADOVANI MD (PRESIDENT)
(209) 529-9603
Entity
Organization
Contact information
Practice address
1421 OAKDALE ROAD, MODESTO, CA 95355
(209) 572-2700
Mailing address
817 COFFEE ROAD, C3, MODESTO, CA 95355
(209) 529-9603
(209) 529-6610
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G44340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G443400
—
CA
Enumeration date
11/14/2006
Last updated
08/22/2020
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