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First Choice Physician Partners

Organization Active NPI Neurological Surgery Physician · Modesto, CA

NPI 1104183052 · NPPES record last updated Jun 6, 2016

Key facts

NPI
1104183052
Entity type
Organization (NPI type 2)
Primary specialty
Neurological Surgery Physician 207T00000X
Legal business name
FIRST CHOICE PHYSICIAN PARTNERS
Practice address
205 W Granger Ave
Ste. D
Modesto, CA 95350-4402
Phone
(209) 571-0288
Fax
(209) 571-0327
NPI assigned
Apr 17, 2012
Organization subpart
Yes
Parent organization (as reported)
FIRST CHOICE PHYSICIAN PARTNERS

Authorized official

Name
Mr. Jeff Koury
Title
Ceo
Phone
(714) 428-6842

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 628

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

View all 628

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120710000480 CA Part B Supplier - Clinic/Group Practice 0941465322 Receives reassigned benefits from 479 practitioners
24 other NPIs on this enrollment

National Provider Directory

Part of
First Choice Phys Partners

Locations

58457 29 Palms Hwy
Ste 200
Yucca Valley, CA 92284
Phone (760) 228-1813

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207T00000X Yes

Addresses

Primary practice location

205 W Granger Ave
Ste. D
Modesto, CA 95350-4402

Mailing address

1541 Florida Ave
Ste. 200
Modesto, CA 95350-4429
Phone (209) 214-7053

Other names

  • Greater Modesto Medical Surgical Associates Doing business as

Other providers in Modesto, CA

All providers in Modesto, CA · Neurological Surgery Physician in California

Sources for this page

Verify at the official NPI Registry.