Organization
MODESTO RADIOLOGICAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E MOORE (CFO)
(209) 577-4444
Entity
Organization
Contact information
Practice address
1202 CHELSHURST WAY, SPRING, TX 77379-3247
(559) 455-4009
Mailing address
1524 MCHENRY AVE STE 430, MODESTO, CA 95350-4567
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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