OrganizationActive
Sutter Gould Medical Foundation
NPI 1174570964 · Internal Medicine Physician · Lodi, CA
Provider details
- NPI number
- 1174570964
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Steven Mitnick, Medical Director(209) 521-6097
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Obstetrics & Gynecology Physician207V00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
999 S Fairmont Ave
#130/135
Lodi, CA 95240-5100
Phone: (209) 366-2001
Approximate (ZIP-level) locationGet directions
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Other names (DBA / former)
- Doing business as
- Fairmont Ave Care Center
Registry dates
- Enumerated
- 2006-05-27
- Last updated
- 2010-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.