Ignacio, Elmer Pedere

Ignacio, Elmer Pedere is an individual health care provider with primary practice located at 1524 Mchenry Ave. Ste. 450, Modesto CA 95350. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Ignacio, Elmer Pedere can be contacted via phone (209) 557-6201.

Contact Information

Primary practice address
1524 Mchenry Ave. Ste. 450 Modesto CA 95350
Phone: (209) 557-6201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A42103 California

Profile Details

NPI number 1578507604
LBN Legal business name Ignacio, Elmer Pedere
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578507604 NPPES
California MEDICAID 3427319

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