SUTTER GOULD MEDICAL FOUNDATION (NPI# 1285886515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285886515 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Other Organization Name | SGMF INDEPENDENT CLINICAL LABORATORY |
| Practice Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2095241211 |
| Mailing Telephone | 2095216097 |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2014-04-01 |
| 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 | 291U00000X | Clinical Medical Laboratory | 05D0610690 | CA | Laboratories |
| Other Name | Type Code |
|---|---|
| SGMF Independent Clinical Laboratory | 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 |
| 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 |
600 COFFEE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073517751 | Kishore K. Kalluri | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2005-06-09 |
| 1508405622 | Erica Corral-ruiz | Registered Nurse | 600 Coffee Rd, Modesto, CA 95355-4201 | 2020-01-06 |
| 1598324519 | Cierra Coffman | Physician Assistant | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-06-12 |
| 1053879932 | Anitha Choorakulam George | Nurse Practitioner | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-03-09 |
| 1154852994 | Simran Kaur Bains | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2017-03-23 |
| 1891246153 | Pacific Infectious Diseases, Inc. | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-10-20 |
| 1497108062 | Palvasha Shah | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355 | 2016-07-19 |
| 1861845430 | Bharati Meesala | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-07-19 |
| 1376999672 | David William Lowry | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-05-05 |
| 1245692250 | Swathi S.b. Kari | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952849499 | Ez Sleep Club, Inc. | Clinical Medical Laboratory | 5039 Pentecost Dr Ste D, Modesto, CA 95356-9290 | 2017-02-04 |
| 1932248465 | Unilab Corporation | Clinical Medical Laboratory | 1401 Spanos Crt, Ste 107b, Modesto, CA 95355-2812 | 2007-02-05 |
| 1528095015 | Doctors Medical Center | Clinical Medical Laboratory | 730 Mchenry Avenue, Modesto, CA 95350-5413 | 2006-06-28 |
| 1629059746 | Sutter Central Valley Hospitals | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2005-11-07 |
| 1770943276 | Sutter Central Valley Hospitals | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2016-02-26 |
| 1285009035 | Sutter Valley Medical Foundation | Clinical Medical Laboratory | 600 Coffee Rd, Modesto, CA 95355-4201 | 2015-12-04 |
| 1639492317 | County of Stanislaus | Clinical Medical Laboratory | 820 Scenic Dr, Modesto, CA 95350-6131 | 2010-03-09 |
| 1881830040 | Valley Interventional Pain Medical Grp | Clinical Medical Laboratory | 1524 Mchenry Ave, #445, Modesto, CA 95350 | 2008-12-18 |
| 1750556718 | Yosemite Pathology Medical Group, Inc | Clinical Medical Laboratory | 1700 Coffee Rd, Modesto, CA 95355-2803 | 2008-04-29 |
| 1831364140 | Yosemite Pathology Medical Group | Clinical Medical Laboratory | 1441 Florida Ave, Modesto, CA 95350-4405 | 2008-04-28 |
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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.