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General NPI Number Information
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NPI Number | 1992665996
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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 | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 4480 WILLOW RD
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City | PLEASANTON
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State | CA
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Zip | 94588-8519
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Country | US
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Telephone | 650-934-7000
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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 | SENIOR DIRECTOR PLANNING AND ALIGNM
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Name | KRISTIN KELLER
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Credential |
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Telephone | 650-934-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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