Ladan Modallel
MD | Pediatrics | Female
Ladan Modallel, MD is a San Bernardino, California based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Ladan Modallel is
742 W Highland Ave, San Bernardino, California - 92405-3839. She can be contacted on phone at
909-386-1880 and fax number 909-386-1882.
Ladan Modallel is a sole proprietor of her business.
NPI number (Unique professional ID) for Ladan Modallel is
1669633376 which was assigned by NPPES on 24 Jun, 2008 and it was last updated on 07 Mar, 2023.
Ladan Modallel license number is
MD60914735 for Pediatrics (208000000X) in Washington.
Ladan Modallel is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Ladan Modallel basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Ladan Modallel |
|---|
| Credential : | MD |
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| Gender : | Female |
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Business Address:
Ladan Modallel address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 742 W Highland Ave
San Bernardino, CA, 92405-3839
United States |
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| Phone Number : | 909-386-1880 |
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| Fax Number : | 909-386-1882 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1669633376 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 24 Jun, 2008 |
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| Last Updated On : | 07 Mar, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ladan Modallel are as mentioned. Primary taxonomy code for Ladan Modallel, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 117285 | CA |
| 208000000X | Pediatrics | No | 44915 | KY |
| 208000000X | Pediatrics | Yes | MD60914735 | WA |
Legacy Identifiers:
Other legacy medical identifiers of Ladan Modallel such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 2122359 | MEDICAID | WA | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
1550 S PIONEER WAY STE 200,
MOSES LAKE, WA, 98837-4614
United States | MOSES LAKE, WA | 509-793-9787 |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | lmodallel1203501@wm.providencedirect.org
EPIC EMR | No affiliation | DIRECT
Direct
|
| 1550 S Pioneer Way Ste 200,
Moses Lake, WA, 98837-4614
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1574 W Base Line St Ste 107
San Bernardino, CA, 92411-1736
United States |
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| Phone Number : | 909-386-1880 |
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| Fax Number : | 909-386-1882 |
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Business Location:
Patients can refer following map for directions to
Ladan Modallel practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.