SUTTER GOULD MEDICAL FOUNDATION (NPI# 1104083377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104083377 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Practice Address |
3585 Gorge Pl Carlsbad CA 92010-7083 |
| Mailing Address |
600 Coffee Rd Physician Services Modesto CA 95355-4201 |
| Practice Telephone | 2095216097 |
| Mailing Telephone | 2095216097 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | STEVEN A MITNICK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2095216097 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235576885 | Sutter Gould Medical Foundation | Pharmacist | 2160 Encinal Ave, Alameda, CA 94501-4322 | 2013-05-22 |
| 1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
| 1124068879 | Sutter Gould Medical Foundation | Family Medicine | 800 Douglas Rd, Stockton, CA 95207-3607 | 2006-06-08 |
| 1316993611 | Sutter Gould Medical Foundation | Radiology | 3846 Cascadia Ave S, Seattle, WA 98118-1129 | 2006-05-26 |
| 1528362050 | Sutter Gould Medical Foundation | Clinic/Center | 415 E Harding Way, Suite E, Stockton, CA 95204-6118 | 2010-12-23 |
| 1588803373 | Sutter Gould Medical Foundation | Clinic/Center | 1409 E Briggsmore Ave, Modesto, CA 95355-2707 | 2009-02-18 |
| 1285886515 | Sutter Gould Medical Foundation | Clinical Medical Laboratory | 600 Coffee Rd, Modesto, CA 95355-4201 | 2008-10-17 |
| 1154352771 | Sutter Gould Medical Foundation | Internal Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2006-07-05 |
| 1982648580 | Sutter Gould Medical Foundation | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-06-15 |
| 1477593176 | Sutter Gould Medical Foundation | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2006-06-08 |
| Street Address |
3585 GORGE PL |
| City | CARLSBAD |
| State | CA |
| Zip Code | 92010-7083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730554551 | Sutter Valley Medical Foundation | Radiology | 3585 Gorge Pl, Carlsbad, CA 92010-7083 | 2015-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730796145 | Makiki Kemmochi | Dietitian, Registered | 3527 Simsbury Court, Carlsbad, CA 92010 | 2020-09-29 |
| 1538795679 | Tanner Sean Harvey | Military Health Care Provider | 1mrb Bas, Apo, AA 92010 | 2020-03-20 |
| 1356882237 | Mary H Currier | Speech-Language Pathologist | 5651 Palmer Way, Suite D, Carlsbad, CA 92010 | 2017-03-13 |
| 1275968166 | Laurie Kristine Tarter | Counselor | 2888 Loker Ave E, 110, Carlsbad, CA 92010 | 2013-09-10 |
| 1184861171 | Albert Joseph Macksood | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5509 Coyote Ct., Carlsbad, CA 92010 | 2009-01-13 |
| 1386700458 | Terri Brusseau Kraus | Physical Therapist | 3222 Grey Hawk Court, Carlsbad, CA 92010 | 2006-12-30 |
| 1073537726 | Janet M Fagan | Social Worker | Va San Diego 3350 La Jolla Village Drive, Social Work Service, San Diego, CA 92010 | 2006-07-26 |
| 1669711883 | Stephen Kihagi Runyora | Pharmacist | 2509 Via Sorbete, Carlsbad, CA 92010-1352 | 2013-02-07 |
| 1366080079 | Sandra Alfaro | Registered Nurse | 3204 Via De Canto, Carlsbad, CA 92010-1354 | 2019-12-12 |
| 1265744551 | Robert C Lloyd | Marriage & Family Therapist | 2809 Via Topacio, Carlsbad, CA 92010-1358 | 2010-07-02 |
| Find all providers in zip 92010 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083154827 | Quantum Medical Radiology of California, P.C. | Radiology | 1412 Sapphire Dr, Carlsbad, CA 92011-1200 | 2017-02-27 |
| 1992936652 | Kennewick Radiology Group PC | Radiology | 3548 Avenida Pantera, Carlsbad, CA 92009-8939 | 2009-07-29 |
| 1205917150 | Medical Imaging of Carlsbad Pa | Radiology | 411 N Canyon, Carlsbad Medical Center, Carlsbad, NM 88220 | 2006-10-18 |
| 1386742401 | Afsaneh Maghsoudy | Radiology | 6010 Hidden Valley Rd Ste 125, Carlsbad, CA 92011-4219 | 2006-09-20 |
| 1073619094 | Barry Blair Campbell | Radiology | 7141 Argonauta Way, Carlsbad, CA 92009-6507 | 2006-09-16 |
| 1972609121 | Lon Babbitt | Radiology | 1803 Mountain Shadow Dr, Carlsbad, NM 88220-4150 | 2006-09-15 |
| 1770554701 | Teresa Anne Deroo | Radiology | 5456 Wolverine Ter, Carlsbad, CA 92010-7159 | 2006-01-28 |
| 1730554551 | Sutter Valley Medical Foundation | Radiology | 3585 Gorge Pl, Carlsbad, CA 92010-7083 | 2015-12-04 |
| 1295816148 | Otoniel R Sullesta | Radiology | 2430 W Pierce St, Carlsbad Medical Center, Carlsbad, NM 88220 | 2006-10-18 |
| 1730278656 | Am & Bb Imaging Center Inc | Radiology | 6010 Hidden Valley Rd, Suite 125, Carlsbad, CA 92011-4213 | 2006-10-11 |
| Find all providers in CARLSBAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.