MEDICARE: COUNTY OF SUTTER

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
1	261QM2500X	Medical Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619194594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF SUTTER

Provider Business Mailing Address
First Line	:	1445 VETERANS MEMORIAL CIR
Second Line	:	ATTN HEALTH DIVISION (CHDP)
City	:	YUBA CITY
State	:	CA
Zip	:	95993-3011
Country	:	US
Telephone Number	:	530-822-7215
Fax Number	:	530-822-7223

Provider Business Practice Location Address
First Line	:	1445 VETERANS MEMORIAL CIR
Second Line	:	ATTN HEALTH DIVISION (CHDP)
City	:	YUBA CITY
State	:	CA
Zip	:	95993-3011
Country	:	US
Telephone Number	:	530-822-7215
Fax Number	:	530-822-7223

Authorized Official
Title or Position	:	DIRECTOR OF HUMAN SERVICES
Name	:	NANCY O'HARA
Credential	:
Telephone Number	:	530-822-7327

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/13/2019

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1445 VETERANS MEMORIAL CIR STE B
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95993-3011

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1356374029 — HEMALATHA VANGALA MD
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1548305147 — LOU ANNE CUMMINGS MD, MPH
Practice Location Address:

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1831226364 — COUNTY OF SUTTER
Practice Location Address:

1445 VETERANS MEMORIAL CIR , ATTN DEPARTMENT OF HUMAN SERVICES
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Practice Location Address:

1445 VETERANS MEMORIAL CIR , ATTN HEALTH DIVISION (PRIMARY CARE)
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1891912770 — COUNTY OF SUTTER
Practice Location Address:

1445 VETERANS MEMORIAL CIR , ATTN HEALTH DIVISION (PUBLIC HEALTH)
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95993-3011

Practice Phone: 530-822-7215
Practice Fax: 530-822-7223

Directions to “COUNTY OF SUTTER ” Practice Location

Language	Start Address	Practice Location

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