Provider Demographics
NPI:1851765184
Name:SUTTER VALLEY MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:SUTTER VALLEY MEDICAL FOUNDATION
Other - Org Name:SGMF DALE ROAD CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SH VP, QUALITY, SAFETY AND PATIENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-384-7544
Mailing Address - Street 1:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:209-524-1211
Mailing Address - Fax:
Practice Address - Street 1:3612 DALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-0500
Practice Address - Country:US
Practice Address - Phone:209-524-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty