Healthcare Provider Details
I. General information
NPI: 1730238007
Provider Name (Legal Business Name): SUTTER BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3555 CESAR CHAVEZ
SAN FRANCISCO CA
94110-4403
US
IV. Provider business mailing address
PO BOX 742412
LOS ANGELES CA
90074-2412
US
V. Phone/Fax
- Phone: 415-600-7180
- Fax: 415-600-7776
- Phone: 855-398-1633
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282E00000X |
| Taxonomy | Long Term Care Hospital |
| License Number | 220000070 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282E00000X |
| Taxonomy | Long Term Care Hospital |
| License Number | |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 220000070 |
| License Number State | CA |
VIII. Authorized Official
Name:
JOHN
B.
GATES
Title or Position: CFO
Credential:
Phone: 510-450-7357