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

Nathan Hallam, PA

Individual provider Physician Assistant · NPI 1720831258

Nathan Hallam, PA is a Physician Assistant in Modesto, California. Qualified in 2024, 2 years ago. Practices with Sutter Valley Medical Foundation, a 2,464-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

600 Coffee Rd
Modesto, CA 95355-4201
Phone: (209) 569-7408
Fax: (209) 491-7587
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 64617 (CA)

Record details

NPI number1720831258
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedApril 5, 2024
Last updated in NPPESOctober 30, 2024
Certification dateOctober 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sutter Valley Medical Foundation — 2464 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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