| Everside-ca Ironworkers-modesta | |
|
2336 Sylvan Ave Ste C Modesto CA 95355-9211 | |
| (704) 661-1380 | |
| Not Available |
| Full Name | Everside-ca Ironworkers-modesta |
|---|---|
| Speciality | Clinic/center |
| Location | 2336 Sylvan Ave Ste C, Modesto, California |
| Authorized Official Name and Position | Jill Johnson Patton (DIRECTOR OF RISK MANAGEMENT) |
| Authorized Official Contact | 7049365546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Everside-ca Ironworkers-modesta 4651 Charlotte Park Dr Ste 300 Charlotte NC 28217-1916 | Everside-ca Ironworkers-modesta 2336 Sylvan Ave Ste C Modesto CA 95355-9211 Ph: (704) 661-1380 |
| NPI Number | 1104517937 |
|---|---|
| Provider Enumeration Date | 05/15/2023 |
| Last Update Date | 09/17/2026 |
| Certification Date | 09/17/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104517937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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