Organization Active NPI

Doctors Primary Care of Modesto, Inc.

  • Family Medicine Physician
  • Modesto, CA
National Provider Identifier
1104065788
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS PRIMARY CARE OF MODESTO, INC.
Practice address
3125 Conant Ave
Modesto, CA 95350-6527
Phone
(209) 524-1668
Fax
(209) 524-0014
NPI assigned
Feb 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Dr. Ronald Kaufman
Title
Regional Cmo; Tenet
Phone
(714) 428-6812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3125 Conant Ave
Modesto, CA 95350-6527

Mailing address

3125 Conant Ave
Modesto, CA 95350-6527
Phone (209) 524-1668

Other names 1

  • Doctors Primary Care Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1104065788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 CONANT AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506527",
            "telephone_number": "209-524-1668",
            "fax_number": "209-524-0014"
        },
        {
            "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": "209-524-1668",
            "fax_number": "209-524-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS PRIMARY CARE OF MODESTO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "REGIONAL CMO; TENET",
        "authorized_official_telephone_number": "714-428-6812",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Primary Care 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 May 26, 2016; 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.