Provider Demographics
NPI:1316014913
Name:SUTTER SOLANO TCU
Entity Type:Organization
Organization Name:SUTTER SOLANO TCU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBO DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-978-8701
Mailing Address - Street 1:PO BOX 160100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-0100
Mailing Address - Country:US
Mailing Address - Phone:800-353-3369
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2578
Practice Address - Country:US
Practice Address - Phone:800-353-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER HEALTH SACRAMENTO SIERRA REGION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-29
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
555627Medicare ID - Type Unspecified