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
1	2080P0207X	Pediatric Hematology & Oncology Physician
2	207RI0008X	Hepatology Physician
3	2083X0100X	Occupational Medicine Physician
4	207RG0100X	Gastroenterology Physician
5	2084N0400X	Neurology Physician
6	207R00000X	Internal Medicine Physician
7	2084P0800X	Psychiatry Physician
8	207RC0000X	Cardiovascular Disease Physician
9	207RN0300X	Nephrology Physician
10	207VM0101X	Maternal & Fetal Medicine Physician
11	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
12	207SG0201X	Clinical Genetics (M.D.) Physician
13	208000000X	Pediatrics Physician
14	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1992258263
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	:	2340 CLAY ST
Second Line	:	FLOORS 1-5 AND 7
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1932
Country	:	US
Telephone Number	:	415-600-1000
Fax Number	:	415-600-1065

Authorized Official
Title or Position	:	SR DIRECTOR, PLANNING AND ALIGNMENT
Name	:	KRISTIN KELLER
Credential	:
Telephone Number	:	650-934-3576

Provider Enumeration Date	:	08/03/2016
Last Update Date	:	03/18/2026

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