Indyana Polley
Physician Assistant

Address: 4009 Eastport Dr, Modesto, CA 95356-8770
Phone: 2093242848

Indyana Polley (NPI# 1679036644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1679036644
Entity Type Individual
Full Name Indyana Polley
Gender Female
Practice Address 4009 Eastport Dr
CA 95356-8770
Practice Telephone 2093242848
Mailing Address 4009 Eastport Dr
CA 95356-8770
Mailing Telephone 2093242848
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2019-04-08
Last Update Date 2019-08-23

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers PA57094 CA
No 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255823191 Laura Lee Ruby Goen Physician Assistant 3105 Mchenry Ave Ste 10, Modesto, CA 95350-1439 2018-06-06
1679086755 Danielle B Deen Physician Assistant 1541 Florida Ave Ste 100, Modesto, CA 95350-4438 2017-11-10
1598292724 Todd Brooks Physician Assistant 1800 Coffee Rd Ste 30, Modesto, CA 95355-2700 2017-05-18
1205240660 David Zarate Rojas Physician Assistant 405 Mid Pines Way, Modesto, CA 95354-3378 2014-06-13
1194151704 Harinder Jhatu Physician Assistant 2218 W Whitmore Ave, Modesto, CA 95358-9497 2013-09-16
1457553885 Michael Tannenbaum Physician Assistant 1808 Scenic Dr, Apt 107, Modesto, CA 95355 2007-06-05
1013139054 Bounchanh Trysavath Physician Assistant 300 I St, Modesto, CA 95351 2007-05-02
1942378583 Karen Fields Physician Assistant Valley Wound Healing Center, 4335a Nstarway, Modesto, CA 95356 2006-12-01
1760594154 Stephen Andrew Fall Physician Assistant 1335 Coffee Rd Ste 100, Modesto, CA 95355-3192 2006-08-31
1194770651 Carolyn Joy Di Francesco Physician Assistant 1441 Florida Avenue, Modesto, CA 95350 2006-05-23
Find all providers in MODESTO

Office Location

Street Address 4009 EASTPORT DR
State CA
Zip Code 95356-8770

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689220279 Meagan Veneman Physical Medicine & Rehabilitation 125 Hogue Rd, Modesto, CA 95356 2019-08-10
1497131213 Hermes Guardian Transport Non-emergency Medical Transport (VAN) 4221 Erin Way, Modesto, CA 95356 2015-08-04
1811373640 Melissa Ruiz Marriage & Family Therapist 5815 Stoddard Rd Suite 600, Modesto, CA 95356 2015-08-04
1922242866 Lifecare Solutions Inc Durable Medical Equipment & Medical Supplies 500 Glass Ln Ste H, Modesto, CA 95356 2009-04-22
1659541647 Ashley Allison Streeter Dentist 556 Lyell Dr, Modesto, CA 95356 2008-03-05
1265636013 Margaret Kathleen Grisell Orthopaedic Surgery 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 2007-06-14
1841412111 Bobby Gene Boswell Specialist/Technologist 3908 Vintage Cove, Modesto, CA 95356 2007-05-03
1598892861 Merritt Radiological Medical Group Inc Radiology 526 Charity Way, Modesto, CA 95356 2007-02-27
1396871091 Michael Steven Beck Social Worker 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 2007-02-26
1659435402 Bryn Elizabeth Miller Dietitian, Registered 3800 Dale Road, Health Education, Modesto, CA 95356 2006-12-19
Find all providers in zip 95356


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Zip Code 95356

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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