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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