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Organization
SUTTER WEST BAY MEDICAL FOUNDATION
Active
Organization
SUTTER WEST BAY MEDICAL FOUNDATION
Active
Parent organization
SUTTER WEST BAY MEDICAL FOUNDATION
Other names
Sutter Pacific Medical Foundation
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUTTER WEST BAY MEDICAL FOUNDATION
Authorized official
JOHN B. GATES (CHIEF FINANCIAL OFFICER)
41560007771
Entity
Organization
Contact information
Practice address
3883 AIRWAY DRIVE, SUITE 120, SANTA ROSA, CA 95403-1678
(707) 521-8966
(707) 523-1301
Mailing address
1700 CALIFORNIA STREET, SUITE 530, SAN FRANCISCO, CA 94109-4591
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
213E00000X
Podiatrist
—
—
225100000X
Physical Therapist
—
—
247100000X
Radiologic Technologist
—
—
291U00000X
Clinical Medical Laboratory
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR00055421
—
CA
05
—
GR0055425
—
CA
05
—
GR0091420
—
CA
Enumeration date
10/14/2009
Last updated
05/21/2010
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