Healthcare Provider Details

I. General information

NPI: 1982845186
Provider Name (Legal Business Name): SUTTER BAY MEDICAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E EL CAMINO REAL SUITE 1 NORTHWEST
MOUNTAIN VIEW CA
94040-2833
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 650-404-8444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: KRISTA LOPES
Title or Position: SH VP, QUALITY, SAFETY, PATIENT EDU
Credential:
Phone: 916-384-7544