Greater Modesto Medical Surgical Associates, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC.

Practice address

3125 Conant Ave
Modesto, CA 95350-6527

Phone

(209) 214-7053

Fax

(209) 523-0764

NPI assigned

Jan 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John R Porteous, M.D.

Title

President

Phone

(209) 577-3388

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1033489307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "SUITE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504423",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 CONANT AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506527",
            "telephone_number": "209-214-7053",
            "fax_number": "209-523-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "PORTEOUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-577-3388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.