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
MR. JOHN GATES (RCFO)
(415) 600-7755
Entity
Organization
Contact information
Practice address
1315 ALHAMBRA BLVD, #210, SACRAMENTO, CA 95816-5244
(916) 732-4380
(916) 739-0893
Mailing address
PO BOX 254947, SACRAMENTO, CA 95865-4947
(916) 854-6975
(916) 854-6844
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0008X
Hepatology Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
CA
Enumeration date
05/14/2009
Last updated
09/25/2013
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