Central California Wellness & Restoration

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G076763 Issued in CA

Legal business name

CENTRAL CALIFORNIA WELLNESS & RESTORATION

Practice address

2004 McHenry Ave
Modesto, CA 95350-3260

Phone

(209) 337-3377

Fax

(209) 729-5353

NPI assigned

Jun 7, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Rocki Cohen

Title

Vice-President

Phone

(209) 595-1408

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Donald Tourtlotte, MD

  • General Practice Physician
  • Stockton, CA
  • NPI 1902955859
  NPD

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437688009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503260",
            "telephone_number": "209-337-3377",
            "fax_number": "209-729-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503260",
            "telephone_number": "209-337-3377",
            "fax_number": "209-729-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA WELLNESS & RESTORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "ROCKI",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "209-595-1408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G076763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Independent Rehabilitative Services, Inc
• Center for Sight of Stockton a Medical Corporation
• Central California Bariatric Surgery a Medical Corporation
• Central California Bariatric Surgery, Partnership
• Central California Cardiac Anesthesia
• Central Star Behavioral Health, Inc.
• Central Valley Behavioral Health Services Inc.
• Central Valley Cpappros, LLC
• Central Valley ENT Medical Group Inc
• Central Valley Functional Restoration Program

• Family Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.