Specialty Medical Group Central California - Dept of Modesto
NPI #1083858492 in Modesto, California
Provider Information
- NPI Number
- 1083858492
- Entity Type
- Organization
- Organization Name
- Specialty Medical Group Central California - Dept of Modesto
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.
- Primary Specialty
- Pediatrics
- Enumeration Date
- Apr 29, 2009
- Last Updated
- Jun 28, 2013
Practice Location
- Address
- 1524 MCHENRY AVE
- Address 2
- 570
- City
- Modesto
- State
- California
- ZIP Code
- 95350-4500
- Phone
- (209) 572-3880
Authorized Official
- Name
- DEVONNA M. KAJI, M.D.
- Title
- PRESIDENT/MEDICAL DIRECTOR
- Phone
- (559) 353-5700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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