Healthcare Provider Details

I. General information

NPI: 1831597517
Provider Name (Legal Business Name): SUTTER WEST BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2014
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5176 HILL RD E MODULAR BUILDING
LAKEPORT CA
95453-6300
US

IV. Provider business mailing address

633 FOLSOM ST 7TH FLOOR
SAN FRANCISCO CA
94107-3600
US

V. Phone/Fax

Practice location:
  • Phone: 707-262-5088
  • Fax: 707-262-5135
Mailing address:
  • Phone: 415-600-7735
  • Fax: 415-600-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOHN GATES
Title or Position: CFO
Credential:
Phone: 415-600-7771