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
3006 S MARYLAND PKWY, #470, LAS VEGAS, NV 89109-2218
(702) 796-9111
(702) 792-9112
Mailing address
PO BOX 254947, SACRAMENTO, CA 95865-4947
(916) 854-6975
(916) 854-6844
Taxonomy
Speciality
Code
Description
License number
State
207RI0008X
Hepatology Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511635 LAS VEGAS
—
NV
05
—
100511636 RENO
—
NV
Enumeration date
05/14/2009
Last updated
09/25/2013
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