Organization Active NPI

Sutter Gould Medical Foundation

  • Family Medicine Physician
  • Turlock, CA
National Provider Identifier
1023065133
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUTTER GOULD MEDICAL FOUNDATION
Practice address
3100 West Christoffersen Parkway
Turlock, CA 95382-9547
Phone
(209) 632-3901
NPI assigned
May 27, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steven A Mitnick, MDNPI 1548285950
Title
Medical Director
Phone
(209) 521-6097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X

Addresses

Primary practice location

3100 West Christoffersen Parkway
Turlock, CA 95382-9547

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

National Provider Directory

National Provider Directory

Locations

999 S Fairmont Ave
Ste 130200
Lodi, CA 95240
Phone (209) 366-2001

1401 Spanos Ct
Ste 111
Modesto, CA 95355
Phone (209) 525-3121

3612 Dale Rd
Modesto, CA 95356
Phone (209) 522-0146

500 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4747

16496 Bernardo Center Dr
#301
San Diego, CA 92128

425 Market St
Fl 26
San Francisco, CA 94105
Phone (415) 995-5050

193 Fairview Ln
Ste E
Sonora, CA 95370
Phone (209) 532-6224

2333 N California St
Stockton, CA 95204
Phone (209) 461-8062

2420 N California St
Stockton, CA 95204
Phone (209) 948-6036

2626 N California St
Ste M
Stockton, CA 95204
Phone (209) 466-2235

415 E Harding Way
Stockton, CA 95204
Phone (209) 943-2041

5345 N El Dorado St
Ste 11
Stockton, CA 95207
Phone (209) 476-1631

75 W March Ln
Ste J
Stockton, CA 95207
Phone (209) 425-4846

800 Douglas Rd
Stockton, CA 95207
Phone (209) 957-7050

83 W March Ln
Ste 2
Stockton, CA 95207
Phone (209) 944-9799

1407 N Tracy Blvd
Tracy, CA 95376
Phone (209) 830-4060

2151 W Grant Line Rd
Tracy, CA 95377
Phone (209) 820-1500

433 W Eaton Ave
Tracy, CA 95376
Phone 20952160975289

447 W Eaton Ave
Tracy, CA 95376
Phone (209) 830-4062

2515 4th Ave
Seattle, WA 98121

Practitioners & affiliated clinicians

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 107

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1023065133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WEST CHRISTOFFERSEN PARKWAY",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953829547",
            "telephone_number": "209-632-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER GOULD MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "MITNICK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-521-6097",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.