NPIMap

Organization Active NPI

Premise Health of California Medical PC

Doing business as Dot Modesto Family Health Center

  • Primary Care Clinic/Center
  • Modesto, CA
National Provider Identifier
1093390031
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PREMISE HEALTH OF CALIFORNIA MEDICAL PC
Doing business as
Dot Modesto Family Health Center
Practice address
2316 Nickerson Dr Ste B
Modesto, CA 95358-9483
Phone
(209) 554-4402
Fax
(209) 551-6690
NPI assigned
Mar 11, 2021
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

2316 Nickerson Dr Ste B
Modesto, CA 95358-9483

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • Dot Modesto Family Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2224603Dot Modesto Family Health Center2316 Nickerson Dr, Ste B, Modesto, CA 95358Certificate of waiverMay 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of California Medical PC55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

2316 Nickerson Dr
Ste B
Modesto, CA 95358
Phone (209) 554-4402

NPI Registry JSON

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1093390031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 NICKERSON DR STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953589483",
            "telephone_number": "209-554-4402",
            "fax_number": "209-551-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF CALIFORNIA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dot Modesto Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.