Mchenry Medical Group, Inc.
LBN: Mchenry Medical Group, Inc.
Mchenry Medical Group, Inc. is an health care organization with primary practice located at 200 Cottage Ave Sute 101, Manteca CA 95336-4935. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Urology is the primary health care specialty.
Mchenry Medical Group, Inc. can be contacted via phone (209) 239-6005, or through Goodman, Harris Michael via phone (209) 577-3388.
Contact Information
Primary practice address
200 Cottage Ave Sute 101
Manteca CA 95336-4935
Phone: (209) 239-6005
Fax:
Website:
Authorized official contact:
Name: Goodman, Harris Michael Doctor of Medicine (MD)
Phone: (209) 577-3388
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X |
Profile Details
| NPI number | 1912183153 |
|---|---|
| LBN Legal business name | Mchenry Medical Group, Inc. |
| DBA Doing business as | |
| Authorized official | Goodman, Harris Michael Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 17th, 2008 |
| Last updated | Jan 17th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912183153 | NPPES |
| California | Other | ZZZ48224Z | MEDICARE # |
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