Organization
SUTTER LAKESIDE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MATHER (CEO)
(707) 263-1877
Entity
Organization
Contact information
Practice address
5176 HILL RD E, LAKEPORT, CA 95453-6300
(707) 262-5001
(707) 262-5513
Mailing address
5176 HILL RD E, LAKEPORT, CA 95453-6300
(707) 262-5513
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
110000094
CA
Other
Enumeration date
08/22/2006
Last updated
10/16/2008
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