Sutter Central Valley Hospitals

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

SUTTER CENTRAL VALLEY HOSPITALS

Doing business as

Memorial Emergency Physicians Associates Medical Group

Practice address

1700 Coffee Rd
Modesto, CA 95355-2803

Phone

(209) 569-7172

Fax

(209) 569-7634

NPI assigned

Feb 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stan Bryda

Title

Director

Phone

(209) 572-7172

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Memorial Emergency Physicians Associates Medical Group Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antonio Kobyashi Coirin, M.D.

  • Trauma Surgery Physician
  • Modesto, CA
  • NPI 1275573446
  NPD (past)
• Peter Vaughn Hull, M.D

  • Emergency Medicine Physician
  • Sun City, AZ
  • NPI 1255384640
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1982678587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COFFEE RD",
            "address_2": "SUITE 87",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552705",
            "telephone_number": "209-569-7532",
            "fax_number": "209-569-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-569-7172",
            "fax_number": "209-569-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER CENTRAL VALLEY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "BRYDA",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "209-572-7172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID CCS",
            "identifier": "CGP161014",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0044240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Emergency Physicians Associates Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Emergency Medical Associates
• Sutter Gould Medical Foundation
• Sutter Gould Medical Foundation
• Sutter Gould Medical Foundation
• Sutter Gould Medical Foundation

• Emergency Medical Services (Emergency Medicine) Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.