Provider Demographics
NPI:1962833319
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:KOUREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-428-6842
Mailing Address - Street 1:1079 EUCALYPTUS ST
Mailing Address - Street 2:SUITE #A
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-4317
Mailing Address - Country:US
Mailing Address - Phone:209-239-6008
Mailing Address - Fax:209-239-3408
Practice Address - Street 1:1079 EUCALYPTUS ST
Practice Address - Street 2:SUITE #A
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4317
Practice Address - Country:US
Practice Address - Phone:209-239-6008
Practice Address - Fax:209-239-3408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST CHOICE PHYSICIAN PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-11
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty