Healthcare Provider Details

I. General information

NPI: 1861582645
Provider Name (Legal Business Name): SUTTER EAST BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DWIGHT WAY
BERKELEY CA
94704-2608
US

IV. Provider business mailing address

PO BOX 742920
LOS ANGELES CA
90074-2920
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4444
  • Fax:
Mailing address:
  • Phone: 855-398-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number140000004
License Number StateCA

VIII. Authorized Official

Name: MR. BRIAN TRENT HUNTER
Title or Position: VP SHARED SERVICES
Credential:
Phone: 916-297-8555