Healthcare Provider Details

I. General information

NPI: 1659439834
Provider Name (Legal Business Name): SUTTER BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/28/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DUBOCE AVE
SAN FRANCISCO CA
94117-3389
US

IV. Provider business mailing address

PO BOX 742412
LOS ANGELES CA
90074-2412
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-7180
  • Fax: 415-600-7776
Mailing address:
  • Phone: 855-398-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D0962082
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number220000197
License Number StateCA

VIII. Authorized Official

Name: JOHN B. GATES
Title or Position: CFO
Credential:
Phone: 510-450-7357