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NPI Code Detail

MEDICARE: SUTTER VALLEY MEDICAL FOUNDATION

MEDICARE: SUTTER VALLEY MEDICAL FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG32207CA
2207R00000XInternal Medicine PhysicianG25105CA
3207RE0101XEndocrinology, Diabetes & Metabolism PhysicianG41310CA
4208000000XPediatrics PhysicianA16204CA
5332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1356716179
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUTTER VALLEY MEDICAL FOUNDATION
Provider Business Mailing Address
First Line : PO BOX 255228
Second Line :
City : SACRAMENTO
State : CA
Zip : 95865-5228
Country : US
Telephone Number : 209-524-1211
Fax Number :
Provider Business Practice Location Address
First Line : 2505 W HAMMER LN
Second Line :
City : STOCKTON
State : CA
Zip : 95209-2839
Country : US
Telephone Number : 209-957-7050
Fax Number :
Authorized Official
Title or Position : SR. DIRECTOR, PLANNING AND ALIGNMEN
Name : KRISTIN KELLER
Credential :
Telephone Number : 650-934-7000
Provider Enumeration Date : 12/04/2015
Last Update Date : 03/18/2026

Similar Medicare Providers

1063887883 — SUTTER VALLEY MEDICAL FOUNDATION
Practice Location Address:
2545 W HAMMER LN
STOCKTON, CA
95209-2839
Practice Phone: 209-957-7050
Practice Fax:
1720085921 — VICTOR WILLIAM MACKO M.D.
Practice Location Address:
2545 W HAMMER LN
STOCKTON, CA
95209-2839
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1093712200 — KEVIN KAYE MIKAELIAN M.D.
Practice Location Address:
2545 W HAMMER LN
STOCKTON, CA
95209-2839
Practice Phone: 209-957-7050
Practice Fax:
1437156221 — DAVID SCOTT BETHUNE M.D.
Practice Location Address:
2545 W HAMMER LN
STOCKTON, CA
95209-2839
Practice Phone: 209-957-7050
Practice Fax:
1073510871 — JERRY CASE CROOKS M.D.
Practice Location Address:
2545 W HAMMER LN
STOCKTON, CA
95209-2839
Practice Phone: 209-957-7050
Practice Fax:
1790770022 — DANIEL J COOPER DO
Practice Location Address:
2505 W HAMMER LN
STOCKTON, CA
95209-2839
Practice Phone: 209-957-7050
Practice Fax:

Directions to “SUTTER VALLEY MEDICAL FOUNDATION ” Practice Location

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