Modic, Frank Edward

Modic, Frank Edward is an individual health care provider with primary practice located at 121 Sotoyome St , Santa Rosa CA 95405-4823. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Modic, Frank Edward can be contacted via phone (707) 546-4062.

Contact Information

Primary practice address
121 Sotoyome St Santa Rosa CA 95405-4823
Phone: (707) 546-4062
Fax: (707) 525-4097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X G56491 California
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X G56491 California
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X G56491 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G56491 California

Profile Details

NPI number 1871683326
LBN Legal business name Modic, Frank Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated May 29th, 2014 - about 10 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 1871683326 NPPES
California MEDICAID 00G564910

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