THEODORE E. STAAHL MD INC
Ambulatory Health at Spanos Ct, Modesto, CA

License number
California G37452
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: MRS. NANCY STAAHL
Title: ADMINISTRATOR/OFFICE MANAGER
Phone: (209) 577-5700
Address
Address
1329 Spanos Ct SUITE A-1, Modesto, CA 95355
National Provider ID: 1467767541
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THEODORE E. STAAHL, M.D., INC

1329 Spanos Ct #A-1, Modesto, CA 95355

Industry:
Plastic Surgeon
Registration:
Jan 1, 1995
State ID:
C1919775
Business type:
Articles of Incorporation
President:
Theodore E. Staahl (President)
Agent:
Theodore E. Staahl, M.d,Modesto, CA 95355 (Physical)

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