Healthcare Provider Details

I. General information

NPI: 1487632055
Provider Name (Legal Business Name): SUTTER BUTTES IMAGING MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 SHASTA ST
YUBA CITY CA
95991-4114
US

IV. Provider business mailing address

945 SHASTA ST
YUBA CITY CA
95991-4114
US

V. Phone/Fax

Practice location:
  • Phone: 530-671-8564
  • Fax: 530-671-8592
Mailing address:
  • Phone: 530-671-8564
  • Fax: 530-671-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: ART HEALY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 530-671-8564