FAIRMONT AVE CARE CENTER
NPI 1174570964
Internal Medicine in Lodi, CA

Q: What is Sutter Gould Medical Foundation's NPI number?

The NPI number for Sutter Gould Medical Foundation is 1174570964. It was assigned to this organization in the NPPES registry on May 27, 2006. The provider is doing business as Fairmont Ave Care Center.

Q: What is Sutter Gould Medical Foundation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 27, 2006CLIA 05D0706846 · Microscopy

999 S FAIRMONT AVE, #130/135, LODI, CA 95240(209) 366-2001 Get Directions Write a Review

NPPES record last updated: May 6, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Fairmont Ave Care Center NPPES

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

FAIRMONT AVE CARE CENTER (NPI 1174570964) is a healthcare organization registered as an internal medicine in Lodi, California and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through September 24, 2026 and lists Steven A Mitnick, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1174570964

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameSUTTER GOULD MEDICAL FOUNDATION

Location Address999 S FAIRMONT AVE, #130/135Lodi, CA 95240-5100

Mailing Address600 Coffee RdModesto, CA 95355-4201 · (209) 524-1211

Phone(209) 366-2001

Organization SubpartNo

Authorized OfficialSteven A MitnickMedical Director · (209) 521-6097

Enumeration DateMay 27, 2006

Last NPPES UpdateMay 6, 2010

✔ NPI 1174570964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

999 S FAIRMONT AVE, Lodi, CA 95240

Open in Google Maps ↗

Other Names 1

Doing Business AsFairmont Ave Care Center

Other Identifiers 2

Medicare ID-Type UnspecifiedZZZ20685ZCA · Medicare Number

Medicare NSC0586060021CA

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

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) 05D0706846

Sutter Gould Medical Foundation-Lodi Obgyn · Lodi, CA

Active · expires Sep 24, 2026

CLIA Number05D0706846

Laboratory TypePhysician Office

Certificate Effective DateSeptember 25, 2024

Certificate Expiration DateSeptember 24, 2026

Laboratory DirectorPatricia Kennel

Laboratory Phone(209) 334-3322

Laboratory LocationSutter Gould Medical Foundation-Lodi Obgyn999 S Fairmont Ave Ste 200, Lodi, CA 95240

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.

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.

DR. DENNY SCHOCH M.D.

Surgery

999 S FAIRMONT AVE, SUITE 100
LODI, CA 95240

San Joaquin County (209) 334-2010

JAMES S. HOFF, M.D., A MEDICAL CORPORATION

Internal Medicine

999 S FAIRMONT AVE, SUITE 135
LODI, CA 95240

San Joaquin County (209) 224-5719

P. GILL OBSTETERICS & GYNECOLOGY MEDICAL GROUP, INC

Registered Nurse

999 S FAIRMONT AVE, STE. 230
LODI, CA 95240

San Joaquin County (209) 334-4924

DIANNA AKESH

Registered Nurse

999 S FAIRMONT AVE
LODI, CA 95240

San Joaquin County (209) 334-0799

WALEED IBRAHIM M.D., INC.

Internal Medicine (Gastroenterology)

999 S FAIRMONT AVE, STE. 115
LODI, CA 95240

San Joaquin County (209) 334-7559

P. GILL OBSTETRICS & GYNECOLOGY MEDICAL GROUP, INC.

Obstetrics & Gynecology

999 S FAIRMONT AVE, STE 230
LODI, CA 95240

San Joaquin County (209) 465-5550

JOSEPH D GAYAGOY M.D.

Internal Medicine

999 S FAIRMONT AVE, SUITE 135
LODI, CA 95240

San Joaquin County (209) 366-2060

LODI MEMORIAL HOSPITAL ASSOCIATION INC

Clinic/Center

999 S FAIRMONT AVE, SUITE 100
LODI, CA 95240

San Joaquin County (209) 334-2010

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 1174570964. It was assigned to this organization in the NPPES registry on May 27, 2006. The provider is doing business as Fairmont Ave Care Center.

Where is Sutter Gould Medical Foundation located?

Sutter Gould Medical Foundation is located at 999 S Fairmont Ave #130/135, Lodi, CA 95240. The listed phone number is (209) 366-2001.

What is Sutter Gould Medical Foundation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Sutter Gould Medical Foundation hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0706846) is associated with this NPI, valid through September 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sutter Gould Medical Foundation was last updated on May 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.