Active NPI
Charles O. Slocumb MD Med Corp
- Gynecology Physician
- Modesto, CA
National Provider Identifier
1669686606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- C30130
- Legal business name
- CHARLES O. SLOCUMB MD MED CORP
- Practice address
- 1541 Florida Ave
Suite 304
Modesto, CA 95350-4429 - Phone
- (209) 576-3832
- NPI assigned
- May 9, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles O. Slocumb, M.D.
- Title
- President
- Phone
- (209) 576-3832
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | C30130 | CA | Primary |
Addresses
Primary practice location
1541 Florida Ave
Suite 304
Modesto, CA 95350-4429
Mailing address
1541 Florida Ave
Suite 304
Modesto, CA 95350-4429
Phone (209) 576-3832
National Provider Directory
National Provider DirectoryLocations
1524 McHenry Ave
Ste 252
Modesto, CA 95350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232928000000",
"number": "1669686606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1541 FLORIDA AVE",
"address_2": "SUITE 304",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504429",
"telephone_number": "209-576-3832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1541 FLORIDA AVE",
"address_2": "SUITE 304",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504429",
"telephone_number": "209-576-3832"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLES O. SLOCUMB MD MED CORP",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-09",
"last_updated": "2009-01-26",
"status": "A",
"authorized_official_last_name": "SLOCUMB",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "O.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "209-576-3832",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CA",
"license": "C30130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.