Provider Demographics
NPI:1124021035
Name:BIREN, CATHERINE A (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:BIREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 NELSON AVE
Mailing Address - Street 2:STE B
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5341
Mailing Address - Country:US
Mailing Address - Phone:209-524-9481
Mailing Address - Fax:209-524-9486
Practice Address - Street 1:1324 NELSON AVE
Practice Address - Street 2:STE B
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5341
Practice Address - Country:US
Practice Address - Phone:209-524-9481
Practice Address - Fax:209-524-9486
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGR0045780174400000X
CAG48190207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG48190Medicare UPIN
CAZZZ23160ZMedicare ID - Type Unspecified