GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC. (NPI# 1134499411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134499411 |
| Entity Type | Organization |
| Organization Name | GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC. |
| Practice Address |
1262 E North St Suite B Manteca CA 95336-4962 |
| Mailing Address |
1541 Florida Ave Suite 200 Modesto CA 95350-4423 |
| Practice Telephone | 2092147053 |
| Practice Fax Number | 2095230764 |
| Mailing Telephone | 2095773388 |
| Mailing Fax Number | 2095230764 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | MR. JOHN R PORTEOUS (PRESIDENT) |
| Authorized Official Telephone | 2095773388 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033489307 | Greater Modesto Medical Surgical Associates, Inc. | Family Medicine | 3125 Conant Ave, Modesto, CA 95350-6527 | 2012-01-04 |
| 1801181151 | Greater Modesto Medical Surgical Associates, Inc. | Neurological Surgery | 205 W Granger Ave, Modesto, CA 95350-4402 | 2011-06-15 |
| 1548494974 | Greater Modesto Medical Surgical Associates, Inc. | Urology | 200 Cottage Ave, Suite 101, Manteca, CA 95336-4935 | 2009-05-13 |
| 1407080823 | Greater Modesto Medical Surgical Associates, Inc. | Urology | 1000 Delbon Ave, #2, Turlock, CA 95382-2008 | 2009-05-13 |
| Street Address |
1262 E NORTH ST SUITE B |
| City | MANTECA |
| State | CA |
| Zip Code | 95336-4962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447258272 | Bliss Watson Clark II | Orthopaedic Surgery | 1262 E North St, Manteca, CA 95336-4962 | 2005-07-14 |
| 1891250197 | Paola Velosa | Nurse Practitioner | 1262 E North St, Manteca, CA 95336 | 2019-01-31 |
| 1821355777 | First Choice Physician Partners | Ophthalmology | 1262 E North St, Ste B, Manteca, CA 95336-4962 | 2012-04-17 |
| 1447543160 | Gail R Joseph | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336-4962 | 2011-05-27 |
| 1386943546 | Janna Bernice Brocchini | Registered Nurse | 1262 E North St, Manteca, CA 95336-4962 | 2011-03-26 |
| 1386821452 | Linda L Pickhartz | Nurse Practitioner | 1262 E North St, Manteca, CA 95336-4962 | 2008-01-30 |
| 1952586067 | M. Jacqueline Galang Inc. | Internal Medicine | 1262 E North St, Manteca, CA 95336 | 2008-01-08 |
| 1992819957 | Prayuk A. Waran | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336 | 2006-08-18 |
| 1326094715 | Edward Joseph Stanford | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336 | 2006-05-26 |
| 1437113065 | Manteca Medical Group, Inc | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336-4962 | 2006-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
| Find all providers in zip 95336 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457337362 | Ronald Ryo Yamada | Orthopaedic Surgery | 1191 E Yosemite Ave, Ste 203, Manteca, CA 95336-5011 | 2005-12-22 |
| 1659715639 | First Choice Physician Partners | Orthopaedic Surgery | 1234 E North St, # 103, Manteca, CA 95336-4960 | 2013-04-22 |
| 1760724637 | First Choice Physician Partners | Orthopaedic Surgery | 1234 E North St, Ste 103, Manteca, CA 95336-4960 | 2013-03-19 |
| 1871698993 | Jeffrey O Mcgillicuddy | Orthopaedic Surgery | 1234 E North St, Suite 103, Manteca, CA 95336-4960 | 2006-09-13 |
| 1164475109 | Ronald R. Yamada, M.d., Inc | Orthopaedic Surgery | 1234 E North St, Suite 103, Manteca, CA 95336-4960 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163382 | San Bernardino Medical Orthopaedic Group Inc | Orthopaedic Surgery | 8805 Haven Ave Ste 100, Rancho Cucamonga, CA 91730-5149 | 2020-10-30 |
| 1376142067 | San Bernardino Medical Orthopaedic Gro | Orthopaedic Surgery | 4500 Brockton Ave Ste 306, Riverside, CA 92501-4027 | 2020-10-22 |
| 1699372326 | Adventist Health Physicians Network | Orthopaedic Surgery | 84 Madrone St Ste A, Willits, CA 95490-4249 | 2020-10-06 |
| 1982215992 | Roshan T Melvani Md Inc | Orthopaedic Surgery | 12677 Hesperia Rd Ste 140, Victorville, CA 92395-7735 | 2020-08-13 |
| 1164033684 | First Care Multispecialty Medical Group, Inc. | Orthopaedic Surgery | 4401 Atlantic Ave Ste 480, Long Beach, CA 90807-2265 | 2020-08-10 |
| 1194343855 | Orthopaedic Group of Orange County | Orthopaedic Surgery | 1200 N Tustin Ave Ste 250, Santa Ana, CA 92705-3596 | 2020-07-09 |
| 1497372536 | Kaley Brown Surgical Pa | Orthopaedic Surgery | 360 Tom Mcguinness Jr Cir, Fallbrook, CA 92028-2623 | 2020-07-05 |
| 1982220612 | Advanced Orthopaedic Surgeons At Long Beach, Inc | Orthopaedic Surgery | 1760 Termino Ave Ste 208, Long Beach, CA 90804-2151 | 2020-06-18 |
| 1982227609 | Sun Medical Group Huntington, Inc | Orthopaedic Surgery | 7801 Center Ave Ste 203, Huntington Beach, CA 92647-9118 | 2020-05-28 |
| 1932722733 | Julian Hakim Baloyan | Orthopaedic Surgery | 333 H St Ste 5000503, Chula Vista, CA 91910-5555 | 2020-05-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.