STOCKTON MEDICAL PLAZA PRIMARY CARE
NPI 1154352771
Family Medicine in Stockton, CA

Active since July 05, 2006CLIA Certified · 6 labs
2505 W HAMMER LN, STOCKTON, CA 95209(209) 957-7050 Get Directions Write a Review

NPPES record last updated: October 3, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Stockton Medical Plaza Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STOCKTON MEDICAL PLAZA PRIMARY CARE (NPI 1154352771) is a healthcare organization registered as a family medicine in Stockton, California and active in the NPI registry since July 2006. The organization holds 6 active CLIA laboratory certificates and lists Steven A Mitnick, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1154352771
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSUTTER GOULD MEDICAL FOUNDATION
Location Address2505 W HAMMER LNStockton, CA 95209-2839
Mailing Address600 Coffee RdModesto, CA 95355-4201 · (209) 524-1211
Organization SubpartNo
Authorized OfficialSteven A MitnickMedical Director · (209) 521-6097
Enumeration DateJuly 5, 2006
Last NPPES UpdateOctober 3, 2012
NPI 1154352771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · G32207
Definition

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License G25105 (CA)
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X · License G41310 (CA)
Also ListedPediatricsTaxonomy 208000000X · License A16204 (CA)
2505 W HAMMER LN, Stockton, CA 95209

Other Names 1

Doing Business AsStockton Medical Plaza Primary Care

Other Identifiers 2

Medicare PINZZZ20685ZCA
Medicare NSC0586060024CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 6

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0609099

Sutter Gould Medical Foundation - Smp I Obgyn & Derm · Stockton, CA
Active · expires Sep 24, 2027
CLIA Number05D0609099
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2025
Certificate Expiration DateSeptember 24, 2027
Laboratory DirectorJennifer T. Phung
Laboratory Phone(209) 956-1552
Laboratory LocationSutter Gould Medical Foundation - Smp I Obgyn & Derm2505 W Hammer Lane, Stockton, CA 95209
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 05D2020368

Sutter Gould Medical Foundation- Smp Ii- Urgent Care · Stockton, CA
Active · expires Feb 16, 2027
CLIA Number05D2020368
Laboratory TypePhysician Office
Certificate Effective DateFebruary 17, 2025
Certificate Expiration DateFebruary 16, 2027
Laboratory DirectorMing Zhou, MD
Laboratory Phone(209) 954-4040
Laboratory LocationSutter Gould Medical Foundation- Smp Ii- Urgent Care2505 W Hammer Ln, Stockton, CA 95209
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 05D2007262

Sutter Gould Medical Foundation Lab - Stockton · Stockton, CA
Active · expires Dec 20, 2026
CLIA Number05D2007262
Laboratory TypeAmbulatory
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorDr. Ming Zhou
Laboratory Phone(209) 872-6017
Laboratory LocationSutter Gould Medical Foundation Lab - Stockton2505 W Hammer Lane, Stockton, CA 95209
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 05D0609318

Sutter Gould Medical Foundation Endocrinology Smp II · Stockton, CA
Active · expires Mar 2, 2028
CLIA Number05D0609318
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateMarch 2, 2028
Laboratory DirectorKhin Ma
Laboratory Phone(209) 943-2041
Laboratory LocationSutter Gould Medical Foundation Endocrinology Smp II2545 W Hammer Lane, Stockton, CA 95209
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D1096997

Sutter Gould Medical Foundation Dba Stockton Surgery Center · Stockton, CA
Active · expires Mar 16, 2027
CLIA Number05D1096997
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 17, 2025
Certificate Expiration DateMarch 16, 2027
Laboratory DirectorChai Jie Chang
Laboratory Phone(209) 955-3001
Laboratory LocationSutter Gould Medical Foundation Dba Stockton Surgery Center8011 Don Avenue, Stockton, CA 95209
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2155425

Sutter Gould Medical Foundation · Stockton, CA
Active · expires Dec 8, 2026
CLIA Number05D2155425
Laboratory TypePhysician Office
Certificate Effective DateDecember 9, 2024
Certificate Expiration DateDecember 8, 2026
Laboratory DirectorJohn O. Olowoyeye
Laboratory Phone(209) 287-9561
Laboratory LocationSutter Gould Medical Foundation2545 W Hammer Lane Smp II, Stockton, CA 95209
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
2505 W HAMMER LN
STOCKTON, CA 95209
Allergy & Immunology
2505 W HAMMER LN
STOCKTON, CA 95209
Physician Assistant
2505 W HAMMER LN
STOCKTON, CA 95209
Urology
2505 W HAMMER LN
STOCKTON, CA 95209
Internal Medicine
2505 W HAMMER LN
STOCKTON, CA 95209
Family Medicine
2505 W HAMMER LN
STOCKTON, CA 95209
Hospitalist
2505 W HAMMER LN
STOCKTON, CA 95209
Family Medicine
2505 W HAMMER LN
STOCKTON, CA 95209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sutter Gould Medical Foundation's NPI number?

The NPI number for Sutter Gould Medical Foundation is 1154352771. It was assigned to this organization in the NPPES registry on July 5, 2006. The provider is doing business as Stockton Medical Plaza Primary Care.

Where is Sutter Gould Medical Foundation located?

Sutter Gould Medical Foundation is located at 2505 W Hammer Ln, Stockton, CA 95209. The listed phone number is (209) 957-7050.

What is Sutter Gould Medical Foundation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Sutter Gould Medical Foundation hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Sutter Gould Medical Foundation was last updated on October 3, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.