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NPI 1902520455

NPI 1902520455 : SUTTER BAY MEDICAL FOUNDATION : E PALO ALTO, CA

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General NPI Number Information
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    NPI Number           |    1902520455
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    Entity Type          |    Organization 
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    Legal Business Name  |    SUTTER BAY MEDICAL FOUNDATION 
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Dates
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    Enumeration Date     |    09/28/2022
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    Last Update Date     |    10/28/2024
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Provider Practice Location Address
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    Address Line         |    1950 UNIVERSITY AVE 
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    City                 |    E PALO ALTO
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    State                |    CA
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    Zip                  |    94303-2250
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    Country              |    US
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    Telephone            |    650-853-2948
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 276950 
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95827-6950
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    Country              |    US
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    Telephone            |    
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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        |    291U00000X
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    Taxonomy Name        |    Clinical Medical Laboratory
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    License Number       |    
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    License Number State |    
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