STOCKTON SURGERY CENTER – NPI #1316190796
Clinic/Center

STOCKTON SURGERY CENTER is an AHC clinic located in STOCKTON, CA. NPPES has assigned the NPI number 1316190796 to STOCKTON SURGERY CENTER on October 29, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “STOCKTON SURGERY CENTER” is a dba name, the actual legal business name for this organization is SUTTER GOULD MEDICAL FOUNDATION. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 6 years ago on Mar 06, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STOCKTON SURGERY CENTER below.

NPI Profile for
SUTTER GOULD MEDICAL FOUNDATION

NPI Number
1316190796
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SUTTER GOULD MEDICAL FOUNDATION
Doing Business As (dba): STOCKTON SURGERY CENTER
Primary location
8011 DON AVE
STOCKTON, CA 95209
Phone: (209) 955-3047 Fax:
Mailing address
Same as primary location
Organization Subpart
Yes - STOCKTON SURGERY CENTER is subpart of another organization.
Authorized Official
STEVEN MITNICK
MEDICAL DIRECTOR
Phone: (209) 521-6097
Updated
Certification Date
Mar 06, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.