OrganizationActive
Modesto Neonatal Medical Group, Inc.
NPI 1912197294 · Neonatal-Perinatal Medicine Physician · Modesto, CA
Provider details
- NPI number
- 1912197294
- Entity type
- Organization
- Primary specialty
- Neonatal-Perinatal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gina Wallace, Billing Agent(209) 571-8330
- License
- 39491 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
1441 Florida Ave
Modesto, CA 95350-4405
Phone: (209) 571-8330
Street-level locationGet directions
Mailing address
Po Box 577558
Modesto, CA 95357-7558
Registry dates
- Enumerated
- 2007-08-01
- Last updated
- 2007-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.