Whalio Doctors

NPI 1154352771

Sutter Gould Medical Foundation

Organisation Family Medicine Physician Stockton, CA

Practice location

Address
2505 W Hammer Ln, Stockton, CA 95209-2839
Phone
(209) 957-7050
Mailing address
600 Coffee Rd, Modesto, CA 95355-4201

Authorised official

Name
Steven a Mitnick
Title
Medical Director
Phone
(209) 521-6097

Registered specialties (4)

Family Medicine Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence G32207 (CA)
Internal Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence G25105 (CA)
Endocrinology, Diabetes & Metabolism Physician
Allopathic & Osteopathic Physicians Taxonomy 207RE0101X Licence G41310 (CA)
Pediatrics Physician
Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence A16204 (CA)

Registry record

NPI
1154352771
Entity type
Organization
NPI issued
5 Jul 2006
Record last updated
3 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.