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Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN A MITNICK MD (MEDICAL DIRECTOR)
(209) 521-6097
Entity
Organization
Contact information
Practice address
3100 WEST CHRISTOFFERSEN PARKWAY, TURLOCK, CA 95382-9547
(209) 632-3901
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
Other
Enumeration date
05/27/2006
Last updated
09/24/2015
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