NPIMap

Organization Active NPI

Sunshine Womens Medical Center

  • Obstetrics & Gynecology Physician
  • Modesto, CA
National Provider Identifier
1659448173
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A71560 Issued in CA
Legal business name
SUNSHINE WOMENS MEDICAL CENTER
Practice address
4213 Dale Rd
Suite 1
Modesto, CA 95356-8505
Phone
(209) 543-7400
Fax
(209) 543-7403
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Catherine Sook Song, MDNPI 1548255888
Title
Ceo
Phone
(209) 543-7400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A71560 CA Primary

Addresses

Primary practice location

4213 Dale Rd
Suite 1
Modesto, CA 95356-8505

Mailing address

4213 Dale Rd
Suite 1
Modesto, CA 95356-8505
Phone (209) 543-7400

Other identifiers 4

IdentifierTypeStateIssuer
00A715600MedicaidCA
3613034MedicaidCA
00A715600OtherCABLUESHIELD PROVIDER NUMBE
7442284OtherCABLUECROSS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

4213 Dale Rd
Ste 1
Modesto, CA 95356
Phone (209) 492-0735

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659448173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 DALE RD",
            "address_2": "SUITE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568505",
            "telephone_number": "209-543-7400",
            "fax_number": "209-543-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 DALE RD",
            "address_2": "SUITE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568505",
            "telephone_number": "209-543-7400",
            "fax_number": "209-543-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE WOMENS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "SOOK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-543-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A71560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A715600",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3613034",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD PROVIDER NUMBE",
            "identifier": "00A715600",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS PROVIDER NUMBER",
            "identifier": "7442284",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.