Provider Demographics
NPI:1154467595
Name:SUTTER NORTH MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:SUTTER NORTH MEDICAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-749-3330
Mailing Address - Street 1:969 PLUMAS ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16911 WILLOW GLEN ROAD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95919
Practice Address - Country:US
Practice Address - Phone:530-675-2458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0598790007Medicare NSC