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Mr. David Garth Ellertson SR., MD
Vascular Surgery Physician in Modesto, California
NPI 1912964495

David Garth Ellertson SR. is a Vascular Surgery Physician based in Modesto, CA and is specialized in Vascular Surgery. David Garth Ellertson SR. practices in Modesto, CA and has the professional credentials of MD. The NPI Number for David Garth Ellertson SR. is 1912964495 and holds a License No. G17987 (California).

The current practice location address for David Garth Ellertson SR. is 4101 Tully Rd, Modesto, CA and can be reached out via phone at 209-524-8346 and via fax at 209-524-7723.

Location: 4101 Tully Rd, Modesto, CA, 95356-8980
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912964495
Provider Name
David Garth Ellertson SR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4101 Tully Rd, Modesto, CA, 95356-8980
Phone Number
209-524-8346
Fax Number
209-524-7723
Provider Enumeration Date
04/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
20014578 01 CA MEDICARE ID
institution
Provider Business Practice Location Address Details
Address
4101 Tully Rd
City
Modesto
State
California
Zip
95356-8980
Phone Number
209-524-8346
Fax Number
209-524-7723
person
Provider Business Mailing Address Details
Address
4101 Tully Rd
City
Modesto
State
California
Zip
95356-8980
Phone Number
209-524-8346
Fax Number
209-524-7723
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
G17987 (California)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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