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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LADAN MODALLEL, MD

Active

LADAN MODALLEL, MD is a Pediatrics healthcare provider located in SAN BERNARDINO, California. NPI 1669633376 is currently active in the NPPES registry. Verify at CMS.

Pediatrics · SAN BERNARDINO, CA

Registration Details

NPI Number
1669633376
Provider Type
Individual
Gender
Female
NPI Issued
Jun 24, 2008 (18.102629465859 yrs)
Last Updated
Aug 18, 2025
Licenses
44915 (KY)
MD60914735 (WA)
117285 (CA)

Practice Information

Address
1574 W BASE LINE ST STE 107
SAN BERNARDINO, CA, 924111736
Browse CA providers · Browse ZIP 92411
Phone
9093861880
Fax
9093861882
Primary Specialty
Pediatrics
208000000X
Additional Specialty
Pediatrics
Additional Specialty
Pediatrics

Other Pediatrics Providers in SAN BERNARDINO, CA

Name Credential NPI
DR. KOFI ADADE-BOAFO M.D. 1003898792
JESUSA AQUINO M.D 1538122106
PHILIP CHAOTSAI CHIEN M.D. 1205885985
GAIL MARKS MD 1700813698
SWAPNA S. KUDTARKAR M.D. 1104939172
CATHERINE TAN M.D. 1598870248
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.