Healthcare Provider Details

I. General information

NPI: 1285641167
Provider Name (Legal Business Name): SUTTER COAST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 E. WASHINGTON BLVD. SUITE 10
CRESCENT CITY CA
95531-8343
US

IV. Provider business mailing address

800 E. WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-8818
  • Fax: 707-464-8848
Mailing address:
  • Phone: 707-464-8511
  • Fax: 707-464-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MITCH HANNA
Title or Position: CEO
Credential:
Phone: 707-464-8880