Provider Demographics
NPI:1033124409
Name:SUTTER REGIONAL MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:SUTTER REGIONAL MEDICAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:APPENZELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7074-340-2049
Mailing Address - Street 1:PO BOX 254978
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-4978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2578
Practice Address - Country:US
Practice Address - Phone:707-551-3600
Practice Address - Fax:707-551-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ01965ZMedicare ID - Type Unspecified