NPIMap

Organization Active NPI

Sutter Valley Medical Foundation

Doing business as Stockton Medical Plaza Specialty Care

  • Durable Medical Equipment & Medical Supplies
  • Stockton, CA
National Provider Identifier
1063887883
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUTTER VALLEY MEDICAL FOUNDATION
Doing business as
Stockton Medical Plaza Specialty Care
Practice address
2545 W Hammer LN
Stockton, CA 95209-2839
Phone
(209) 957-7050
NPI assigned
Dec 4, 2015
Last updated
Oct 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

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

Authorized official

Name
Leia M Sanders
Title
Sr Director, Cred, Enroll, Alignmen
Phone
(650) 934-7000

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2545 W Hammer LN
Stockton, CA 95209-2839

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (209) 524-1211

Other names 1

  • Stockton Medical Plaza Specialty Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160531002097 CA DME Supplier - Multi-Specialty - Physician 9830094515 Practice locations: Stockton, CA

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Mark C Maltzer MD36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1063887883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-957-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER VALLEY MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "LEIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR DIRECTOR, CRED, ENROLL, ALIGNMEN",
        "authorized_official_telephone_number": "650-934-7000"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stockton Medical Plaza Specialty Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stockton Medical Plaza Specialty Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.