Healthcare Provider Details

I. General information

NPI: 1093106247
Provider Name (Legal Business Name): SUTTER WEST BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 CLAY ST 5TH FLOOR, OPHTHALMOLOGY DEPARTMENT
SAN FRANCISCO CA
94115-1932
US

IV. Provider business mailing address

2340 CLAY ST 5TH FLOOR, OPHTHALMOLOGY DEPARTMENT
SAN FRANCISCO CA
94115-1932
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-3901
  • Fax:
Mailing address:
  • Phone: 415-600-3901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberA121642
License Number StateCA

VIII. Authorized Official

Name: TALIVA MARTIN
Title or Position: RESIDENCY DIRECTOR
Credential: MD
Phone: 415-600-3901