Nineveh Outreach

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

550001116 Issued in CA

Legal business name

NINEVEH OUTREACH

Practice address

1601 Coffee Rd
Modesto, CA 95355-2801

Phone

(209) 529-7346

Fax

(209) 529-7034

NPI assigned

Aug 14, 2012

Organization subpart

Yes

Parent organization

CALVARY TEMPLE WORSHIP CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Manuel L Canga, M.D.

Title

Medical Director

Phone

(209) 529-7346

Specialties & licenses 1

Addresses

Other names 1

• Hope Medivan Doing business as

Locations

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1366799801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 578901",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953578901",
            "telephone_number": "209-529-7346",
            "fax_number": "209-529-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552801",
            "telephone_number": "209-529-7346",
            "fax_number": "209-529-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINEVEH OUTREACH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALVARY TEMPLE WORSHIP CENTER",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "CANGA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-529-7346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "550001116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hope Medivan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avtarinder Kaur Nijjar, M.D.
• Angelica Hermelinda Nila
• Niloofar Deyhim DDS Inc
• Matthew Nilsen, DABR
• Jayshri Mahesh Nimbargi, MD
• Marica Nino, MD
• Thomas Nipper, RN
• Nirmal S Rai MD and Meetinder K Rai MD Inc
• Nirmal S Rai MD Inc
• Nirvana Drug and Alcohol

• Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.