SUTTER GOULD MEDICAL FOUNDATION NPI 1104083377

NPI Information

  • NPI: 1104083377
  • Provider Name: SUTTER GOULD MEDICAL FOUNDATION
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 05D1100601
  • Address: 3585 GORGE PL
    CARLSBAD, CA
    ZIP 92010
  • Phone: (209) 521-6097

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NPI Details

SUTTER GOULD MEDICAL FOUNDATION is a diagnostic radiology radiology in Carlsbad, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SUTTER GOULD MEDICAL FOUNDATION NPI is 1104083377. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3585 GORGE PL
CARLSBAD, CA
ZIP 92010-083
Phone: (209) 521-6097

The provider's authorized official is Steven A Mitnick .
The authorized official title is Medical Director and has the following contact phone number (209) 521-6097.

The CLIA number assigned to this NPI record is 05D1100601 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2008 and was last updated on 5/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1AX453MEDICARE PINCALIFORNIA
2AV838AMEDICARE PINCALIFORNIA
3CB228203MEDICARE PINCALIFORNIA
4W22630MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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