SUTTER GOULD MEDICAL FOUNDATION (NPI# 1558301713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558301713 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Other Organization Name | COFFEE ROAD CARE CENTER |
| Practice Address |
1144 Coffee Rd Modesto CA 95355-4205 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2095504744 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2010-05-06 |
| 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 |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coffee Road Care Center | 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 |
1144 COFFEE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982660122 | Yvonne J Brouard | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-04-25 |
| 1861837171 | Anirudh Saronwala | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355 | 2013-05-01 |
| 1699902338 | Christopher Tizon Ostrea | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2009-06-21 |
| 1053445676 | Jeanette Marie Merchant | Marriage & Family Therapist | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2007-03-15 |
| 1134171754 | Angela I Lin | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-05-16 |
| 1780632091 | Deborah A Shassetz | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-05-05 |
| 1801854419 | Alberto Cajigas | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-05-03 |
| 1245298884 | Arlaine B Gutierrez | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-05-03 |
| 1730147604 | Robert D Fromuth | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-05-02 |
| 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 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922569698 | Andrea Marie Peterson | Pediatrics | 1917 Lakeshore Dr, Modesto, CA 95355-1869 | 2019-03-26 |
| 1679025837 | Marcella Murphy | Pediatrics | 2904 Century Pl, Modesto, CA 95355-8736 | 2016-11-03 |
| 1619008661 | Mohammad Javaid Bhatti | Pediatrics | 1325 Blakely Ln, Modesto, CA 95356-8984 | 2007-03-08 |
| 1528103330 | Pamela A Zachar | Pediatrics | Doctors Medical Center, 1441 Florida Avenue, Modesto, CA 95350 | 2007-02-20 |
| 1972642239 | Javier Valero Fonseca | Pediatrics | 1524 Mchenry Ave Ste 570, Modesto, CA 95350-4574 | 2007-02-05 |
| 1285729830 | Rosy Shah | Pediatrics | 700 17th Street, Modesto, CA 95354 | 2006-10-03 |
| 1518991983 | Armand Richaud Hernandez | Pediatrics | 1329 Spanos Ct Ste C4, Modesto, CA 95355-2806 | 2006-07-10 |
| 1982660122 | Yvonne J Brouard | Pediatrics | 1144 Coffee Rd, Modesto, CA 95355-4205 | 2006-04-25 |
| 1679555213 | Antonio E. Apellanes | Pediatrics | 2101 Tenaya Dr, Modesto, CA 95354-3930 | 2005-11-18 |
| 1588646004 | Anuradha Dubey | Pediatrics | 4312 Spyres Way, Modesto, CA 95356-9259 | 2005-11-18 |
| Find all providers in MODESTO | ||||
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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.