Healthcare Provider Details

I. General information

NPI: 1720463391
Provider Name (Legal Business Name): SUTTER COAST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

IV. Provider business mailing address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-8511
  • Fax: 707-464-8941
Mailing address:
  • Phone: 707-464-8511
  • Fax: 707-464-8941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MITCH HANNA
Title or Position: CEO
Credential:
Phone: 707-464-8511