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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