| Hope Medivan | |
|
1601 Coffee Rd Modesto CA 95355-2801 | |
| (209) 529-7346 | |
| (209) 529-7034 |
| Full Name | Hope Medivan |
|---|---|
| Speciality | Clinic/center |
| Location | 1601 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | Manuel L Canga (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2095297346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Medivan Po Box 578901 Modesto CA 95357-8901 Ph: (209) 529-7346 | Hope Medivan 1601 Coffee Rd Modesto CA 95355-2801 Ph: (209) 529-7346 |
| NPI Number | 1366799801 |
|---|---|
| Provider Enumeration Date | 08/14/2012 |
| Last Update Date | 08/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366799801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 550001116 (California) | Primary |
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