Organization
WELLBOUND OF MODESTO LLC
Active
Organization
WELLBOUND OF MODESTO LLC
Active
Parent organization
WELLBOUND LLC
Other names
WellBound of Modesto
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLBOUND LLC
Authorized official
THOMAS L WEINBERG (CHAIRMAN)
(214) 736-2700
Entity
Organization
Contact information
Practice address
1315 10TH ST, SUITE 100, MODESTO, CA 95354-0714
(209) 238-4080
(209) 238-4084
Mailing address
300 SANTANA ROW, 300, SAN JOSE, CA 95128-2423
(209) 238-4080
(650) 625-6007
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC52524F
—
CA
Enumeration date
02/03/2006
Last updated
05/15/2024
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