MEDICARE: SUTTER VALLEY MEDICAL FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1174997407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUTTER VALLEY MEDICAL FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 255228
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-5228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2995 AMERICAN RIVER LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1713
Country	:	US
Telephone Number	:	209-521-6097
Fax Number	:

Authorized Official
Title or Position	:	SH VP, QUALITY, SAFETY AND PATIENT
Name	:	KRISTA LOPES
Credential	:
Telephone Number	:	916-384-7544

Provider Enumeration Date	:	11/24/2015
Last Update Date	:	10/29/2024

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Directions to “SUTTER VALLEY MEDICAL FOUNDATION ” Practice Location

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