Healthcare Provider Details

I. General information

NPI: 1154467595
Provider Name (Legal Business Name): SUTTER NORTH MEDICAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16911 WILLOW GLEN ROAD
BROWNSVILLE CA
95919
US

IV. Provider business mailing address

969 PLUMAS ST SUITE 205
YUBA CITY CA
95991-4011
US

V. Phone/Fax

Practice location:
  • Phone: 530-675-2458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAVID YAMAMOTO
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 530-749-3330