Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ladan Modallel, MD

Individual provider Pediatrics Physician · NPI 1669633376

Ladan Modallel, MD is a Pediatrics Physician in San Bernardino, California. Works from 2 locations. Licensed in California, Kentucky and Washington.

Licensed in
CA, KY, WA
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1574 W Base Line St Ste 107
San Bernardino, CA 92411-1736
Phone: (909) 386-1880
Fax: (909) 386-1882
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1550 S Pioneer Way Ste 200, Moses Lake, WA 98837-4614 — (509) 793-9787

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 117285 (CA)
Pediatrics Physician Taxonomy 208000000X · Licence 44915 (KY)
Pediatrics Physician Taxonomy 208000000X · Licence MD60914735 (WA)

Record details

NPI number1669633376
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 24, 2008
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

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