SUTTER GOULD MEDICAL FOUNDATION (NPI# 1477593176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477593176 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Other Organization Name | STOCKTON MEDICAL PLAZA SPECIALTY CARE |
| Practice Address |
2545 W Hammer Ln Stockton CA 95209-2839 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2099577050 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-03-19 |
| 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 | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Stockton Medical Plaza Specialty 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 |
| 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 |
| Street Address |
2545 W HAMMER LN |
| City | STOCKTON |
| State | CA |
| Zip Code | 95209-2839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720085921 | Victor William Macko | Orthopaedic Surgery | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2005-07-01 |
| 1720602709 | Helena Astani | Physician Assistant | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2020-06-04 |
| 1881143832 | Stephanie Borja-johnson | Audiologist | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2016-09-30 |
| 1063887883 | Sutter Valley Medical Foundation | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2015-12-04 |
| 1740690718 | Nataliya Vang | Obstetrics & Gynecology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2014-04-30 |
| 1811317241 | Lee Mullen | Nurse Practitioner | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2014-04-24 |
| 1194147645 | Sandar Linn | Internal Medicine | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2014-01-16 |
| 1225476500 | Bayan Aghdasi | Orthopaedic Surgery | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2013-06-10 |
| 1669817011 | Lauren Henderson Lomax | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2013-04-29 |
| 1548525967 | Hazel-kay Yurong | Nurse Practitioner | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2012-07-11 |
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| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184038960 | Orest Wesely | Orthopaedic Surgery | 4449 Saint Andrews Dr, Stockton, CA 95219-1849 | 2014-06-19 |
| 1568559037 | Gerald Charles Barnes | Orthopaedic Surgery | 5819 Portage Place, Stockton, CA 95219-3857 | 2006-10-06 |
| 1063467116 | Gary M Alegre | Orthopaedic Surgery | 2488 N California, Alpine Orthopaedic Medical Group Inc, Stockton, CA 95204-5508 | 2006-05-24 |
| 1851381131 | Peter B Salamon | Orthopaedic Surgery | 2488 N California St, Stockton, CA 95204-5508 | 2005-10-26 |
| 1720085921 | Victor William Macko | Orthopaedic Surgery | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2005-07-01 |
| 1225476500 | Bayan Aghdasi | Orthopaedic Surgery | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2013-06-10 |
| 1396023032 | Jaspreet Sidhu | Orthopaedic Surgery | 2488 N California St, Stockton, CA 95204 | 2011-07-29 |
| 1043535081 | Jeffrey J Maclean | Orthopaedic Surgery | 2488 N California St, Stockton, CA 95204-5508 | 2010-04-01 |
| 1801123690 | Jaicharan J. Iyengar | Orthopaedic Surgery | 2488 N California St, Stockton, CA 95204-5508 | 2009-11-16 |
| 1972742427 | Michael Y Lin | Orthopaedic Surgery | 2488 N California St, Stockton, CA 95204-5508 | 2009-02-06 |
| 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.