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Organization

MODESTO RADIOLOGICAL MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL ZEPPA MD (PRESIDENT)
(209) 342-5920
Entity
Organization

Contact information

Practice address
1524 MCHENRY AVE, SUITE 100, MODESTO, CA 95350-4500
(209) 342-5920
Mailing address
1524 MCHENRY AVE STE 420, MODESTO, CA 95350-4567
(209) 342-5920

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2085N0700X
Neuroradiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0043720
CA
05
GR0043722
CA
05
GR0043723
CA
05
GR0043724
CA
05
GR0050090
CA
05
GR0050220
CA
05
GR0050221
CA
05
ZZZ02008Z
CA
05
ZZZ72867Z
CA
05
ZZZ72881Z
CA
05
ZZZ75541Z
CA
05
ZZZ78409Z
CA
Enumeration date
06/11/2006
Last updated
03/24/2026
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