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Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Other names
Dale Road Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN A MITNICK MD (MEDICAL DIRECTOR)
(209) 521-6097
Entity
Organization
Contact information
Practice address
3612 DALE RD, MODESTO, CA 95356-0500
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/24/2006
Last updated
10/03/2012
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