Provider Demographics
NPI:1336543925
Name:ALLCARE HOSPITALIST MEDICAL GROUP, INC
Entity type:Organization
Organization Name:ALLCARE HOSPITALIST MEDICAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS REP
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:STORTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-550-5213
Mailing Address - Street 1:3320 TULLY RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-0800
Mailing Address - Country:US
Mailing Address - Phone:209-550-5253
Mailing Address - Fax:209-338-5674
Practice Address - Street 1:3320 TULLY RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-0800
Practice Address - Country:US
Practice Address - Phone:209-550-5253
Practice Address - Fax:209-338-5674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLCARE HOSPITALIST MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-10
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35619208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty