# SUTTER GOULD MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Briggsmore Specialty Center Ambulatory Surgical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588803373
- **Authorized official:** STEVEN A MITNICK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (209) 521-6097

## Contact information

- **Practice address:** 1409 E BRIGGSMORE AVE, MODESTO, CA 95355-2707
- **Practice address phone:** (209) 524-1211
- **Mailing address:** 600 COFFEE RD, MODESTO, CA 95355-4201
- **Mailing address phone:** (209) 524-1211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | CA | Yes |
| 261QE0800X | Endoscopy Clinic/Center | 10022 | CA | — |

## Other

- **Enumeration date:** 02/18/2009
- **Last updated:** 08/04/2010