OrganizationActive
Everside-Ca Ironworkers-Modesta
NPI 1104517937 · Preventive Medicine/Occupational Environmental Medicine Physician · Modesto, CA
Provider details
- NPI number
- 1104517937
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jill Patton, Director of Risk Management(704) 936-5546
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2336 Sylvan Ave Ste C
Modesto, CA 95355-9211
Phone: (704) 661-1380
Approximate (ZIP-level) locationGet directions
Mailing address
4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916
Registry dates
- Enumerated
- 2023-05-15
- Last updated
- 2023-05-15
- Certified
- 2023-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.