MODESTO NEONATAL MEDICAL GROUP, INC.
NPI 1912197294
Pediatrics - Neonatal-Perinatal Medicine in Modesto, CA

Q: What is Modesto Neonatal Medical Group, Inc.'s NPI number?

The NPI number for Modesto Neonatal Medical Group, Inc. is 1912197294. It was assigned to this organization in the NPPES registry on August 1, 2007.

Q: What is Modesto Neonatal Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Active since August 01, 2007

1441 FLORIDA AVE, MODESTO, CA 95350(209) 571-8330 Get Directions Write a Review

NPPES record last updated: August 1, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Modesto Neonatal Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODESTO NEONATAL MEDICAL GROUP, INC. (NPI 1912197294) is a healthcare organization registered as a neonatal-perinatal medicine in Modesto, California and active in the NPI registry since August 2007. The organization lists Gina Wallace, Billing Agent, as its authorized official.

NPPES Registry Identity

NPI1912197294

Entity TypeOrganization

Primary Taxonomy2080N0001X

Legal Business NameMODESTO NEONATAL MEDICAL GROUP, INC.

Location Address1441 FLORIDA AVEModesto, CA 95350-4405

Mailing AddressPo Box 577558Modesto, CA 95357-7558 · (209) 571-8330 · Fax (209) 491-7184

Phone(209) 571-8330

Organization SubpartNo

Authorized OfficialGina WallaceBilling Agent · (209) 571-8330

Enumeration DateAugust 1, 2007

✔ NPI 1912197294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in CA · 39491

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

1441 FLORIDA AVE, Modesto, CA 95350

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Other Identifiers 2

MedicaidGR0090580CA

OtherZZZ39491ZCA · Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THUY-LIEN THI LE M.D.

Student in an Organized Health Care Education/Training Program