Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Other names
Briggsmore Specialty Center Ambulatory Surgical Center
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
1409 E BRIGGSMORE AVE, MODESTO, CA 95355-2707
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
261QE0800X
Endoscopy Clinic/Center
10022
CA
Other
Enumeration date
02/18/2009
Last updated
08/04/2010
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