Sutter Gould Medical Foundation

NPI #1558301713 in Modesto, California

Provider Information

NPI Number: 1558301713
Entity Type: Organization
Organization Name: Sutter Gould Medical Foundation
Primary Specialty: Pediatrics
Enumeration Date: Jun 7, 2006
Last Updated: May 6, 2010

Practice Location

Address: 1144 COFFEE RD
City: Modesto
State: California
ZIP Code: 95355-4205
Phone: (209) 550-4744

Authorized Official

Name: STEVEN A MITNICK, MD
Title: MEDICAL DIRECTOR
Phone: (209) 521-6097

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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