Healthcare Provider Details

I. General information

NPI: 1902350168
Provider Name (Legal Business Name): SUTTER BAY MEDICAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 SACRAMENTO ST
SAN FRANCISCO CA
94118-1625
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-4280
  • Fax: 415-600-4255
Mailing address:
  • Phone:
  • Fax: 650-696-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

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