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General NPI Number Information
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NPI Number | 1306183421
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Entity Type | Organization
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Legal Business Name | DHP OF SUTTER SOLANO MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 300 HOSPITAL DR
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City | VALLEJO
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State | CA
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Zip | 94589-2574
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Country | US
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Telephone | 707-554-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 400
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 865-693-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUJAL MANDAVIA
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Credential |
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Telephone | 865-693-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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