Healthcare Provider Details

I. General information

NPI: 1992881759
Provider Name (Legal Business Name): SUTTER EAST BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HAWTHORNE AVE
OAKLAND CA
94609-3108
US

IV. Provider business mailing address

PO BOX 742920
LOS ANGELES CA
90074-2920
US

V. Phone/Fax

Practice location:
  • Phone: 510-655-4000
  • Fax:
Mailing address:
  • Phone: 855-398-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140000284
License Number StateCA

VIII. Authorized Official

Name: MR. BRIAN TRENT HUNTER
Title or Position: VP SHARED SERVICES
Credential:
Phone: 916-297-8555