| David H Lyon A Professional Corporation | |
|
4701 Sisk Rd Suite 103 Modesto CA 95356-9320 | |
| (888) 582-0814 | |
| (209) 526-6841 |
| Full Name | David H Lyon A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4701 Sisk Rd, Modesto, California |
| Authorized Official Name and Position | Julie Smith (SUPERVISOR) |
| Authorized Official Contact | 2095527551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David H Lyon A Professional Corporation Po Box 579120 Modesto CA 95357-9120 Ph: (888) 582-0814 | David H Lyon A Professional Corporation 4701 Sisk Rd Suite 103 Modesto CA 95356-9320 Ph: (888) 582-0814 |
| NPI Number | 1649675778 |
|---|---|
| Provider Enumeration Date | 10/31/2014 |
| Last Update Date | 12/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649675778 | NPI | - | NPPES |
| 00A431800 | Other | CA | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 00A431800 (California) | Primary |
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