Provider Demographics
NPI:1871826925
Name:SUTTER BAY HOSPITALS
Entity Type:Organization
Organization Name:SUTTER BAY HOSPITALS
Other - Org Name:SUTTER WEST BAY HOSPITALS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-450-7357
Mailing Address - Street 1:PO BOX 60000
Mailing Address - Street 2:FILE 74175
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94160-0001
Mailing Address - Country:US
Mailing Address - Phone:415-641-2177
Mailing Address - Fax:
Practice Address - Street 1:1580 VALENCIA STREET
Practice Address - Street 2:SUITE 506
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4418
Practice Address - Country:US
Practice Address - Phone:415-647-8111
Practice Address - Fax:415-641-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000097261Q00000X
CA550000230261Q00000X
CA550000228261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA032885OtherVACCINES FOR CHILDREN
CAZZR11829FMedicaid
CACN667AMedicare Oscar/Certification
ZZZ78058ZMedicare Oscar/Certification