Provider Demographics
NPI:1033661681
Name:FRANK FINE, MD
Entity Type:Organization
Organization Name:FRANK FINE, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-748-0080
Mailing Address - Street 1:803 COFFEE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4227
Mailing Address - Country:US
Mailing Address - Phone:209-569-0776
Mailing Address - Fax:
Practice Address - Street 1:803 COFFEE RD
Practice Address - Street 2:4
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4227
Practice Address - Country:US
Practice Address - Phone:209-569-0776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0896337Medicaid
CA0896337Medicaid