Organization Active NPI

Charles O. Slocumb MD Med Corp

  • Gynecology Physician
  • Modesto, CA
National Provider Identifier
1669686606
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
C30130 Issued in CA
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

Updated by the provider on Jan 26, 2009

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)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.