| Crescent Wound Care Inc | |
|
1310 W Granger Ave Modesto CA 95350-3911 | |
| (858) 936-7307 | |
| Not Available |
| Full Name | Crescent Wound Care Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1310 W Granger Ave, Modesto, California |
| Authorized Official Name and Position | Mohamed Kadry-hassanein (PRESIDENT) |
| Authorized Official Contact | 8589673070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Wound Care Inc 5580 La Jolla Blvd # 622 La Jolla CA 92037-7651 Ph: (858) 936-7307 | Crescent Wound Care Inc 1310 W Granger Ave Modesto CA 95350-3911 Ph: (858) 936-7307 |
| NPI Number | 1841920501 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 10/27/2024 |
| Certification Date | 10/27/2024 |
| Medicare PECOS PAC ID | 3274914502 |
|---|---|
| Medicare Enrollment ID | O20220719000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841920501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Karin M Dydell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710094107 PECOS PAC ID: 8224930805 Enrollment ID: I20040123000538 |
| Provider Name | Tuan a Doan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831200526 PECOS PAC ID: 9931184116 Enrollment ID: I20040622000518 |
| Provider Name | Daniel Dean Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033267166 PECOS PAC ID: 8022909860 Enrollment ID: I20040823000722 |
| Provider Name | Abhay Gupta |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1629165428 PECOS PAC ID: 7618920398 Enrollment ID: I20050222000665 |
| Provider Name | Arudi L Prabhakar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396710075 PECOS PAC ID: 3274570437 Enrollment ID: I20050411000283 |
| Provider Name | Daniel H Kosoy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770627259 PECOS PAC ID: 4688689987 Enrollment ID: I20060207001040 |
| Provider Name | Dolores R Kent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366405276 PECOS PAC ID: 9032110549 Enrollment ID: I20070126000139 |
| Provider Name | Syed H Jafar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164437521 PECOS PAC ID: 5193785756 Enrollment ID: I20081120000567 |
| Provider Name | Anisa M Yalom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164679908 PECOS PAC ID: 5799956405 Enrollment ID: I20110928000620 |
| Provider Name | Alfred B Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174508865 PECOS PAC ID: 3072575125 Enrollment ID: I20130207000182 |
| Provider Name | Faisal Amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225328818 PECOS PAC ID: 9335364132 Enrollment ID: I20140711000880 |
| Provider Name | Mohsen a Aljayeh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770785859 PECOS PAC ID: 5698876787 Enrollment ID: I20150702002645 |
| Provider Name | Iosif Kelesidis |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1013154111 PECOS PAC ID: 7911212436 Enrollment ID: I20150812009107 |
| Provider Name | Mohamed Kadry-hassanein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164794673 PECOS PAC ID: 3173812112 Enrollment ID: I20160516000949 |
| Provider Name | Taylor Burch Barnikel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235425547 PECOS PAC ID: 8325269640 Enrollment ID: I20160520001945 |
| Provider Name | Lee K Au |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366458317 PECOS PAC ID: 6002875242 Enrollment ID: I20161005002772 |
| Provider Name | Sandra J Taylor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922089408 PECOS PAC ID: 4981770880 Enrollment ID: I20170419002784 |
| Provider Name | Vincent Covelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528354347 PECOS PAC ID: 4385911924 Enrollment ID: I20170601002153 |
| Provider Name | Cyrus Orandi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356570469 PECOS PAC ID: 0244532661 Enrollment ID: I20170731002885 |
| Provider Name | Sadaf Farasat |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255696407 PECOS PAC ID: 5092095190 Enrollment ID: I20190304000696 |
| Provider Name | Rajiv Kumra |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750581096 PECOS PAC ID: 1557450640 Enrollment ID: I20200520000602 |
| Provider Name | Brendon Bagley |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1669761862 PECOS PAC ID: 7416225743 Enrollment ID: I20200922002355 |
| Provider Name | Najib M Allabadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538692256 PECOS PAC ID: 5890114417 Enrollment ID: I20201001001229 |
| Provider Name | Gregory Caputy |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1194810689 PECOS PAC ID: 7012144769 Enrollment ID: I20201203001004 |
| Provider Name | Ujjala Moolani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528221421 PECOS PAC ID: 2163609900 Enrollment ID: I20210511002851 |
| Provider Name | Andrea a Zaw |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1073994455 PECOS PAC ID: 8527359868 Enrollment ID: I20210708003129 |
| Provider Name | Oscar D Lazcano |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1811337306 PECOS PAC ID: 4587894555 Enrollment ID: I20210825002231 |
| Provider Name | Andrew Kelada |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417488123 PECOS PAC ID: 0042569170 Enrollment ID: I20211015000775 |
| Provider Name | Christopher Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588155477 PECOS PAC ID: 4284980475 Enrollment ID: I20211018002504 |
| Provider Name | Mohammad Yusuf Hanif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851701296 PECOS PAC ID: 7618192881 Enrollment ID: I20220304000731 |
| Provider Name | Meghan M Kubala |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770012684 PECOS PAC ID: 6507137163 Enrollment ID: I20220906001143 |
| Provider Name | Eric Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689080525 PECOS PAC ID: 6800105081 Enrollment ID: I20220908000480 |
| Provider Name | Rajeev Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255891149 PECOS PAC ID: 1052646361 Enrollment ID: I20221128001996 |
| Provider Name | Ollie Jackson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104084698 PECOS PAC ID: 3476707043 Enrollment ID: I20230501002893 |
| Provider Name | Jayson Wisk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821415944 PECOS PAC ID: 0446608798 Enrollment ID: I20231127001647 |
| Provider Name | Michael Zuckerman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003909235 PECOS PAC ID: 6103718630 Enrollment ID: I20231207001855 |
| Provider Name | Hayden Gabriel Schultz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992327605 PECOS PAC ID: 9133562242 Enrollment ID: I20240206001839 |
| Provider Name | Adam Rosendorff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386831444 PECOS PAC ID: 0345398228 Enrollment ID: I20240522000768 |
| Provider Name | Frank Efrem Primus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366734618 PECOS PAC ID: 7214224047 Enrollment ID: I20240814002379 |
| Provider Name | Renee N Carter Owens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891816146 PECOS PAC ID: 0547386625 Enrollment ID: I20241009002335 |
| Provider Name | Ahresh Ranjan Saha |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811579535 PECOS PAC ID: 7517482441 Enrollment ID: I20250423001267 |
| Provider Name | Sharon Mcbeth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699908806 PECOS PAC ID: 4486646080 Enrollment ID: I20250811003382 |
| Provider Name | Kimberly L. Gandy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629041496 PECOS PAC ID: 8628974425 Enrollment ID: I20251022001958 |
| Provider Name | Yusef Jalil Buti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740927664 PECOS PAC ID: 1153817168 Enrollment ID: I20251230000242 |
| Provider Name | Keegan Gies |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922534189 PECOS PAC ID: 4385129832 Enrollment ID: I20260401003199 |
Tushar R. Modi, M.D. Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 413 E Orangeburg Ave Ste A, Modesto, CA 95350 Phone: 209-529-9600 Fax: 209-544-2620 |
Golden Valley Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1510 Florida Ave, Suite B, Modesto, CA 95350 Phone: 209-549-7090 Fax: 209-549-7099 |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1114 6th St, Modesto, CA 95354 Phone: 209-576-2845 Fax: 209-384-3966 |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 Hammond St, Modesto, CA 95351 Phone: 209-576-4437 Fax: 209-384-3966 |
Greater Modesto Medical Surgical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3125 Conant Ave, Modesto, CA 95350 Phone: 209-214-7053 Fax: 209-523-0764 |
Gettysburg Medical Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Coffee Rd, Building 10, Modesto, CA 95355 Phone: 209-725-2060 Fax: 209-725-2072 |