Sutter Gould Medical Foundation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SUTTER GOULD MEDICAL FOUNDATION

Practice address

3132 W March LN
Stockton, CA 95219-2354

Phone

(209) 954-3370

NPI assigned

May 26, 2006

Organization subpart

No

Name

Steven A Mitnick, MD

Title

Medical Director

Phone

(209) 521-6097

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

• Thomas G Salopek, MD

  • Dermatology Physician
  • Modesto, CA
  • NPI 1114983210
  NPD (past)

Tax ID family

Sutter Gould Medical Foundation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Sutter Gould Medical Foundation

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Alameda, CA
  • NPI 1235576885
  NPD tax ID
• Sutter Gould Medical Foundation

  • Ophthalmology Physician
  • Modesto, CA
  • NPI 1801843750
  NPD tax ID

• Brookside Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891741963",
    "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": "3132 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192354",
            "telephone_number": "209-954-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER GOULD MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "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": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0005874",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Susca, PH.D.
• Sara Allison Sutera
• Sutter Gould Medical Foundation
• Sutter Gould Medical Foundation
• Sutter Gould Medical Foundation
• Sutter Hearing Aid Center
• Sutter Valley Medical Foundation
• Sutter Valley Medical Foundation
• Sutter Valley Medical Foundation
• Sutter Valley Medical Foundation

• All providers in Stockton, CA
• Internal Medicine Physician in California

• 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.