Organization
MODESTO GASTROENTEROLOGY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELSAKR MAGDY M.D. (PRESIDENT)
(209) 338-0292
Entity
Organization
Contact information
Practice address
2336 SYLVAN AVE, SUITE A, MODESTO, CA 95355-9211
(209) 338-0292
(209) 338-0298
Mailing address
2336 SYLVAN AVE, SUITE A, MODESTO, CA 95355-9211
(209) 338-0292
(209) 338-0298
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A45724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD2244
MEDICARE ID
CA
Enumeration date
01/23/2007
Last updated
12/27/2022
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