Provider Demographics
NPI:1326139395
Name:RICHARD W. SLOVEK, MD PC
Entity Type:Organization
Organization Name:RICHARD W. SLOVEK, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SLOVEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-668-6449
Mailing Address - Street 1:220 STANDIFORD AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1159
Mailing Address - Country:US
Mailing Address - Phone:209-579-5628
Mailing Address - Fax:209-668-6465
Practice Address - Street 1:1199 DELBON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2015
Practice Address - Country:US
Practice Address - Phone:209-668-6449
Practice Address - Fax:209-668-6465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75660207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2818635Medicaid
CAB67845Medicare UPIN
CAZZZ26968ZMedicare ID - Type UnspecifiedGROUP #