Provider Demographics
NPI:1184336992
Name:PADILLA, FRANKY DANUGRAO
Entity type:Individual
Prefix:MR
First Name:FRANKY
Middle Name:DANUGRAO
Last Name:PADILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 MACGREGOR CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2320
Mailing Address - Country:US
Mailing Address - Phone:571-276-7988
Mailing Address - Fax:
Practice Address - Street 1:2604 MACGREGOR CT
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2320
Practice Address - Country:US
Practice Address - Phone:571-276-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA688180163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic