Greater Modesto Medical Surgical Associates Inc.

NPI #1760616270 in Modesto, California

Provider Information

NPI Number: 1760616270
Entity Type: Organization
Organization Name: Greater Modesto Medical Surgical Associates Inc.
Primary Specialty: Internal Medicine
Enumeration Date: May 12, 2009
Last Updated: Oct 5, 2009

Practice Location

Address: 1541 FLORIDA AVE
Address 2: SUITE 200
City: Modesto
State: California
ZIP Code: 95350-4429
Phone: (209) 577-3388

Authorized Official

Name: MR. JOHN R PORTEOUS, M.D.
Title: SHAREHOLDER
Phone: (209) 577-3388

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Internal Medicine - Endocrinology, Diabetes & Metabolism — Endocrinology, Diabetes & Metabolism	207RE0101X
Internal Medicine - Gastroenterology — Gastroenterology	207RG0100X
Surgery	208600000X
Urology	208800000X
Urology - Pediatric Urology — Pediatric Urology	2088P0231X
Otolaryngology	207Y00000X
Internal Medicine	207R00000X	Primary

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