Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Other names
SGMF Independent Clinical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN A MITNICK M.D. (MEDICAL DIRECTOR)
(209) 521-6097
Entity
Organization
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0610690
CA
Other
Enumeration date
10/17/2008
Last updated
04/01/2014
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