Manteca Medical Group, Inc

LBN: Manteca Medical Group, Inc
Manteca Medical Group, Inc is an health care organization with primary practice located at 1262 E North St , Manteca CA 95336-4962. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Manteca Medical Group, Inc can be contacted via phone (209) 823-7646, or through Croasdale, Terry via phone (209) 823-7646.

Contact Information

Primary practice address
1262 E North St Manteca CA 95336-4962
Phone: (209) 823-7646
Fax: (209) 824-5374
Website:
Map and Directions
Authorized official contact:
Name: Croasdale, Terry Doctor of Medicine (MD)
Phone: (209) 823-7646

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A24460 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A54203 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C43012 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 20A7379 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G55402 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A51139 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A50060 California

Profile Details

NPI number 1437113065
LBN Legal business name Manteca Medical Group, Inc
DBA Doing business as
Authorized official Croasdale, Terry Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2006
Last updated Apr 9th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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