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Organization
SUTTER EAST BAY MEDICAL FOUNDATION
Active
Organization
SUTTER EAST BAY MEDICAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY PROSSER (DIRECTOR PATIENT FINANCIAL SERVICES)
(925) 962-6616
Entity
Organization
Contact information
Practice address
12 CAMINO ENCINAS, ORINDA, CA 94563-3304
(510) 204-8180
Mailing address
PO BOX 254869, SACRAMENTO, CA 95865-4869
(916) 854-6795
(916) 854-6739
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE0013
RAILROAD MEDICARE
CA
01
—
ZZZ663902
BLUE SHIELD
CA
Enumeration date
06/17/2006
Last updated
10/11/2012
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