Organization
SUTTER GOULD MEDICAL FOUNDATION
Active
Other names
Sylvan Eye 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
1011 SYLVAN AVE, #C, MODESTO, CA 95350-1692
(209) 550-4780
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR000587C
—
CA
Enumeration date
05/27/2006
Last updated
08/22/2020
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