Healthcare Provider Details
I. General information
NPI: 1356779797
Provider Name (Legal Business Name): SUTTER BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2013
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5196 HILL RD E SUITE 300
LAKEPORT CA
95453-6360
US
IV. Provider business mailing address
2000 POWELL ST. 10TH FL
EMERYVILLE CA
94608-1804
US
V. Phone/Fax
- Phone: 707-263-6885
- Fax: 707-263-6624
- Phone: 510-450-7347
- Fax: 510-450-7309
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
B.
GATES
Title or Position: CFO
Credential:
Phone: 510-450-7357