Greater Modesto Medical Surgical Associates, Inc.
NPI #1548494974 in Manteca, California
Provider Information
- NPI Number
- 1548494974
- Entity Type
- Organization
- Organization Name
- Greater Modesto Medical Surgical Associates, Inc.
- Primary Specialty
- Urology
- Enumeration Date
- May 13, 2009
- Last Updated
- Oct 5, 2009
Practice Location
- Address
- 200 COTTAGE AVE
- Address 2
- SUITE 101
- City
- Manteca
- State
- California
- ZIP Code
- 95336-4935
- Phone
- (209) 577-3388
Authorized Official
- Name
- MR. JOHN R PORTEOUS, M.D.
- Title
- SHAREHOLDER
- Phone
- (209) 577-3388
Specialties & Taxonomy Codes
| Specialty |
|---|
| Urology - Pediatric Urology — Pediatric Urology |
| Urology |
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