SUTTER GOULD MEDICAL FOUNDATION (NPI# 1154352771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154352771 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Other Organization Name | STOCKTON MEDICAL PLAZA PRIMARY CARE |
| Practice Address |
2505 W Hammer Ln Stockton CA 95209-2839 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2099577050 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-10-03 |
| Authorized Official Name | STEVEN A MITNICK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2095216097 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | G25105 | CA | Allopathic & Osteopathic Physicians |
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
G41310 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | A16204 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | G32207 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Stockton Medical Plaza Primary Care | Doing Business As Name - Organization |
| 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 |
| 1104083377 | Sutter Gould Medical Foundation | Radiology | 3585 Gorge Pl, Carlsbad, CA 92010-7083 | 2008-05-16 |
| 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 |
| 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 |
2505 W HAMMER LN |
| City | STOCKTON |
| State | CA |
| Zip Code | 95209-2839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790770022 | Daniel J Cooper | Family Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2005-09-13 |
| 1902326697 | Arpit Chandrakant Patel | Family Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2017-06-22 |
| 1477084655 | Pei Chuan Bellor-yeh | Family Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2017-03-21 |
| 1386097889 | Dherain Patel | Family Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2016-07-20 |
| 1356716179 | Sutter Valley Medical Foundation | Internal Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2015-12-04 |
| 1366827479 | Sapna Malik | Family Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2015-07-30 |
| 1770986424 | Madhuri Kasireddy | Internal Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2014-10-08 |
| 1588087738 | Seema Abbasi | Internal Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2014-01-23 |
| 1275974701 | Glenda Lando | Nurse Practitioner | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2013-07-12 |
| 1710220454 | Harsimran Singh Basra | Internal Medicine | 2505 W Hammer Ln, Stockton, CA 95209-2839 | 2013-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104272954 | William Luther Bennett | Pharmacist | 1131 Sunnyoak Way, Stockton, CA 95209 | 2016-05-11 |
| 1548686769 | Roland Rillamas Lagpacan | Pharmacist | 3131 West Hammer Lane, Stockton, CA 95209 | 2014-03-12 |
| 1346599677 | Luis Leyva Garcia | Marriage & Family Therapist | 1755 West Hammer Lane, Stockton, CA 95209 | 2012-08-31 |
| 1942506233 | Donna Lynn Peterson | Dentist | 9409 Thornton Rd, Stockton, CA 95209 | 2011-02-03 |
| 1386969798 | Miusotic Zaragoza | Social Worker | 1755 W. Hammer Lane Suite 8, Latino Behavioral Health, Stockton, CA 95209 | 2010-03-30 |
| 1497988844 | Marissa Elizabeth Preciado | Counselor | 10147 River Falls Cir, Stockton, CA 95209 | 2009-09-02 |
| 1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
| 1881845790 | Gary Earl Fiscus | Dentist | 4565 Quail Lakes Drive, Suite A-2, Stockton, CA 95209 | 2008-10-09 |
| 1326225665 | Shirley's Care Home Inc | Intermediate Care Facility, Mentally Retarded | 2330 Shropshire Dr, Stockton, CA 95209 | 2008-01-29 |
| 1134272727 | Joanie Mc Culloch | Homeopath | 8807 Thornton Rd, Ste. P, Stockton, CA 95209 | 2007-01-19 |
| Find all providers in zip 95209 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669081337 | Jagjiwan Kaur Dhatt | Family Medicine | 2426 Swainsons Hawk St, Stockton, CA 95209-4281 | 2020-07-28 |
| 1114167764 | Harshjit Singh | Family Medicine | 7373 West Ln Ste 360, Stockton, CA 95210-3377 | 2009-02-23 |
| 1598928822 | Samira Chaudhry Jahangiri | Family Medicine | 3132 W. March Ln, Stockton, CA 95219 | 2008-07-07 |
| 1316116890 | Rami Georgies | Family Medicine | 8001 Lorraine Ave, Stockton, CA 95210 | 2008-02-28 |
| 1245443654 | Kulendu Ghanshyam Vasavda | Family Medicine | 221 Tuxedo Ct, Suite C, Stockton, CA 95204-5261 | 2007-05-08 |
| 1306990015 | Sierra Occupational Services | Family Medicine | 1429 W Fremont St, Stockton, CA 95203-2627 | 2007-01-22 |
| 1720136138 | Elvis Akpene Tanson | Family Medicine | 4873 West Ln Ste A, Stockton, CA 95210-4548 | 2007-01-08 |
| 1679660088 | Timothy L. H. Yeh | Family Medicine | 1801 E March Ln Ste D460, Stockton, CA 95210-6629 | 2006-10-06 |
| 1386730737 | Timothy Mccarty Coats | Family Medicine | 545 E Cleveland St Ste A, Stockton, CA 95204-5535 | 2006-10-05 |
| 1598876716 | San Tso | Family Medicine | 77 W March Ln, Suite A, Stockton, CA 95207-5723 | 2006-08-31 |
| Find all providers in STOCKTON | ||||
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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.