OrganizationActive
Theodore E. Staahl MD Inc
NPI 1467767541 · Medical Specialty Clinic/Center · Modesto, CA
Provider details
- NPI number
- 1467767541
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Nancy Staahl, Administrator/Office Manager(209) 577-5700
- License
- G37452 (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1329 Spanos Ct
Suite A-1
Modesto, CA 95355-2806
Phone: (209) 577-5700
Fax: (209) 577-5968
Street-level locationGet directions
Mailing address
1329 Spanos Ct
Modesto, CA 95355-2806
Other names (DBA / former)
- Other name
- MD Laser Center
- Other name
- MD Laser Center
Registry dates
- Enumerated
- 2010-08-12
- Last updated
- 2022-11-09
- Certified
- 2022-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.