Bassam Aljomard, MD
Individual provider Active NPI Pediatrics Physician · Modesto, CA
NPI 1093282907 · NPPES record last updated Aug 23, 2021
Key facts
- NPI
- 1093282907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A136340 (CA)
- Practice address
- 1510 Florida Ave
Modesto, CA 95350-4437 - Phone
- (866) 682-4842
- Fax
- (877) 435-6573
- NPI assigned
- Oct 29, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210903000392 | CA | Practitioner - Pediatric Medicine | 7113265158 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A136340 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Valley Health Center | Current |
Accepting new patients | |
| Golden Valley Health Centers | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Centers | Current |
Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Current | Accepting new patients | |
| Golden Valley Health Center | Past | Accepting new patients |
Locations
1405 California Ave
Dos Palos, CA 93620
Phone (209) 392-2111
13161 Jefferson St
Le Grand, CA 95333
Phone (209) 389-1900
821 Texas Ave
Los Banos, CA 93635
Phone (209) 385-5481
250 Northgate Dr
Manteca, CA 95336
Phone (209) 239-5299
797 W Childs Ave
Merced, CA 95341
Phone (209) 383-5871
737 W Childs Ave
Merced, CA 95341
Phone (209) 383-1848
3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104
847 W Childs Ave
Merced, CA 95341
Phone (209) 383-7441
1510 Florida Ave
Modesto, CA 95350
Phone (209) 549-7090
1510 Florida Ave
Ste B
Modesto, CA 95350
Phone (209) 574-1365
1510 Florida Ave
Ste A
Modesto, CA 95350
Phone (209) 492-7150
2101 Tenaya Dr
Modesto, CA 95354
Phone (209) 576-6766
1114 6th St
Modesto, CA 95354
Phone (209) 576-2845
1500 Florida Ave
Modesto, CA 95350
Phone (209) 571-5071
1121 Hammond St
Modesto, CA 95351
Phone (209) 576-4437
637 Merced St
Newman, CA 95360
Phone (209) 862-0270
200 C St
Patterson, CA 95363
Phone (209) 892-6307
9235 E Broadway St
Planada, CA 95365
Phone (209) 382-0253
4150 Patterson Rd
Riverbank, CA 95367
Phone (209) 863-3900
1200 W Main St
Turlock, CA 95380
Phone (209) 668-5388
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | A136340 | CA | Yes |
Addresses
Primary practice location
1510 Florida Ave
Modesto, CA 95350-4437
Mailing address
737 W Childs Ave
Merced, CA 95341-6805
Phone (866) 682-4842
Other practice location 1
7910 Broadway
Elmhurst, NY 11373-1340
Phone (718) 334-4000
Other providers in Modesto, CA
- Mohib Muhammad Ali
- Joseph Christian Alias
- Alignment Healthcare Center
- Rachel Ann Daodao Alikes
- Abdul Mureed Alim
- All About Anesthesia PC
- All Hands Transportation LLC
- All Health Services Corporation
- All Health Services Corporation
- Cami Requel Allard
All providers in Modesto, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.