Provider Demographics
NPI:1104183052
Name:FIRST CHOICE PHYSICIAN PARTNERS
Entity Type:Organization
Organization Name:FIRST CHOICE PHYSICIAN PARTNERS
Other - Org Name:GREATER MODESTO MEDICAL SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-428-6842
Mailing Address - Street 1:1541 FLORIDA AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4429
Mailing Address - Country:US
Mailing Address - Phone:209-214-7053
Mailing Address - Fax:714-428-2315
Practice Address - Street 1:205 W GRANGER AVE
Practice Address - Street 2:STE. D
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4402
Practice Address - Country:US
Practice Address - Phone:209-571-0288
Practice Address - Fax:209-571-0327
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST CHOICE PHYSICIAN PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-17
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty