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NPI Code Detail

MEDICARE: SUTTER BAY MEDICAL FOUNDATION

MEDICARE: SUTTER BAY 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1902520455
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUTTER BAY MEDICAL FOUNDATION
Provider Business Mailing Address
First Line : PO BOX 276950
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-6950
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1950 UNIVERSITY AVE
Second Line :
City : E PALO ALTO
State : CA
Zip : 94303-2250
Country : US
Telephone Number : 650-853-2948
Fax Number :
Authorized Official
Title or Position : SR. DIRECTOR PLANNING AND ALIGNMENT
Name : KRISTIN KELLER
Credential :
Telephone Number : 650-934-3576
Provider Enumeration Date : 09/28/2022
Last Update Date : 03/18/2026

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Directions to “SUTTER BAY MEDICAL FOUNDATION ” Practice Location

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