Organization
SUTTER CENTRAL VALLEY HOSPITALS
Active
Other names
Memorial Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GATES (CFO SHBA)
(510) 450-7357
Entity
Organization
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Mailing address
PO BOX 740152, LOS ANGELES, CA 90074-0152
(855) 398-1633
(209) 572-7772
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
030000061
CA
291U00000X
Clinical Medical Laboratory
05D0609849
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSC00557F
—
CA
05
—
HSP40557F
—
CA
05
—
MTA00603F
—
CA
05
—
ZZR00154F
—
CA
05
—
ZZR00603F
—
CA
Enumeration date
11/07/2005
Last updated
04/21/2016
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