Providence Family Practice Medical Group

LBN: Providence Family Practice Medical Group
Providence Family Practice Medical Group is an health care organization with primary practice located at 1213 Coffee Rd Suite B, Modesto CA 95355-4229. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Providence Family Practice Medical Group can be contacted via phone (209) 491-2500, or through Cronin, Kathie Lee via phone (209) 491-2500.

Contact Information

Primary practice address
1213 Coffee Rd Suite B Modesto CA 95355-4229
Phone: (209) 491-2500
Fax: (209) 491-2545
Website:
Map and Directions
Authorized official contact:
Name: Cronin, Kathie Lee Doctor of Medicine (MD)
Phone: (209) 491-2500

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1104979582
LBN Legal business name Providence Family Practice Medical Group
DBA Doing business as
Authorized official Cronin, Kathie Lee Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2007
Last updated Aug 22nd, 2020 - about 5 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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