SUTTER GOULD MEDICAL FOUNDATION (NPI# 1982648580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982648580 |
| Entity Type | Organization |
| Organization Name | SUTTER GOULD MEDICAL FOUNDATION |
| Other Organization Name | KETTLEMAN CARE CENTER |
| Practice Address |
1335 S Fairmont Ave Lodi CA 95240-5520 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2093662007 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2006-06-15 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Kettleman 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 |
| 1477593176 | Sutter Gould Medical Foundation | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2006-06-08 |
| Street Address |
1335 S FAIRMONT AVE |
| City | LODI |
| State | CA |
| Zip Code | 95240-5520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497712152 | Maria Elena Saluta-ferrer | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-04-27 |
| 1477931178 | Rajvir Singh | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2015-05-13 |
| 1043487663 | Shunmuga Priya Kandaswamy | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2008-05-13 |
| 1558389742 | Nadeem Khan Tahir-kheli | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-07-17 |
| 1689632077 | Paul J Sackschewsky | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-05-03 |
| 1790742146 | David William Duncan | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| 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 |
|---|---|---|---|---|
| 1588919716 | Tareq A Ali Md Apc | Family Medicine | 1520 W Kettleman Ln Ste B, Lodi, CA 95242-9290 | 2012-07-13 |
| 1609147354 | Ruby Kaur Gill | Family Medicine | 999 S Fairmont Ave Ste 235, Lodi, CA 95240-5100 | 2012-01-25 |
| 1114147212 | Frank Silvio Alvarado | Family Medicine | 830 S Ham Lane, Suite 30, Lodi, CA 95240 | 2007-04-30 |
| 1568480556 | Carina Fabiana Gonzalez | Family Medicine | 1300 W Lodi Ave Ste P, Lodi, CA 95242-3038 | 2006-07-17 |
| 1437177755 | Valerie J. Kidd | Family Medicine | 845 S Fairmont Ave Ste 8, Lodi, CA 95240-5113 | 2006-07-17 |
| 1578506952 | Harvey Hashimoto | Family Medicine | 2415 W Vine St, Suite 105, Lodi, CA 95242-3731 | 2006-06-14 |
| 1790722718 | Tareq Ali | Family Medicine | 1520 W Kettleman Ln, Suite B, Lodi, CA 95242-9290 | 2006-05-31 |
| 1497712152 | Maria Elena Saluta-ferrer | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-04-27 |
| 1467417576 | Rian J Podein | Family Medicine | 160 Valley Drive, Lodi, WI 53555 | 2006-04-20 |
| 1790765386 | Kimberly C Sheets | Family Medicine | 225 Elyria St, Lodi, OH 44254 | 2006-01-19 |
| Find all providers in LODI | ||||
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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.