Organization
SUTTER CENTRAL VALLEY HOSPITALS
Active
Organization
SUTTER CENTRAL VALLEY HOSPITALS
Active
Other names
Memorial Emergency Physicians Associates Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STAN BRYDA (DIRECTOR)
(209) 572-7172
Entity
Organization
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 569-7172
(209) 569-7634
Mailing address
1800 COFFEE RD, SUITE 87, MODESTO, CA 95355-2705
(209) 569-7532
(209) 569-7634
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CGP161014
GROUP ID CCS
CA
05
—
GR0044240
—
CA
Enumeration date
02/13/2006
Last updated
04/20/2010
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