Provider Demographics
NPI:1487017471
Name:SUTTER VALLEY HOSPITALS
Entity Type:Organization
Organization Name:SUTTER VALLEY HOSPITALS
Other - Org Name:MEMORIAL HOSPITAL LOS BANOS/RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-887-7050
Mailing Address - Street 1:2700 GATEWAY OAKS DR
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-4337
Mailing Address - Country:US
Mailing Address - Phone:916-887-7040
Mailing Address - Fax:916-887-7041
Practice Address - Street 1:1253 W I ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3930
Practice Address - Country:US
Practice Address - Phone:209-710-6333
Practice Address - Fax:209-827-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA553998Medicare Oscar/Certification