Healthcare Provider Details

I. General information

NPI: 1770726861
Provider Name (Legal Business Name): SUTTER CENTRAL VALLEY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N TRACY BLVD
TRACY CA
95376-3451
US

IV. Provider business mailing address

PO BOX 740152
LOS ANGELES CA
90074-0152
US

V. Phone/Fax

Practice location:
  • Phone: 209-832-6050
  • Fax: 209-832-6091
Mailing address:
  • Phone: 855-398-1633
  • Fax: 209-569-7417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number030000105
License Number StateCA

VIII. Authorized Official

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