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General NPI Number Information
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NPI Number | 1346615150
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Entity Type | Organization
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Legal Business Name | SUTTER VALLEY MEDICAL FOUNDATION
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 1409 E BRIGGSMORE AVE
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City | MODESTO
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State | CA
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Zip | 95355-2707
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Country | US
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Telephone | 209-524-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 600 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-4201
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Country | US
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Telephone | 209-524-1211
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Fax |
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Authorized Official
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Title or Position | SH VP, QUALITY, SAFETY, PATIENT EDU
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Name | KRISTA LOPES
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Credential |
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Telephone | 916-384-7544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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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 | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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