Modesto Anesthesia Medical Group

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

MODESTO ANESTHESIA MEDICAL GROUP

Practice address

1441 Florida Avenue
Modesto, CA 95350-4405

Phone

(209) 576-3514

NPI assigned

Dec 13, 2006

Last updated

Aug 22, 2020By 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

Hwan Kim, M.D.NPI 1245256775

Title

Authorized Official

Phone

20957635414

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.

• Hwan Y Kim, MD

  • Anesthesiology Physician
  • Modesto, CA
  • NPI 1245256775
  NPD (past) Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750443305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVENUE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504405",
            "telephone_number": "209-576-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVENUE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504405",
            "telephone_number": "209-576-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO ANESTHESIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HWAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "20957635414",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.