SUTTER VALLEY MEDICAL FOUNDATION

Provider Demographics

• NPI: 1952327256
• Name: SUTTER VALLEY MEDICAL FOUNDATION
• Entity Type: Organization
• Organization Name: SUTTER VALLEY MEDICAL FOUNDATION
• Authorized Official - Title/Position: DIRECTOR, PHYSICIAN SERVICES
• Authorized Official - Prefix: MS
• Authorized Official - First Name: KRISTIN
• Authorized Official - Last Name: HALLMARK
• Authorized Official - Phone: 916-887-7312
• Mailing Address - Street 1: PO BOX 255225
• Mailing Address - City: SACRAMENTO
• Mailing Address - State: CA
• Mailing Address - Zip Code: 95865-5225
• Mailing Address - Country: US
• Mailing Address - Phone: 800-470-0071
• Mailing Address - Fax: 916-854-6769
• Practice Address - Street 1: 2700 GATEWAY OAKS DR
• Practice Address - City: SACRAMENTO
• Practice Address - State: CA
• Practice Address - Zip Code: 95833-4337
• Practice Address - Country: US
• Practice Address - Phone: 800-470-0071
• Practice Address - Fax: 916-854-6769
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-07-14
• Last Update Date: 2022-12-27

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	261QM1300X	Ambulatory Health Care Facilities	Clinic/Center	Multi-Specialty	Group - Multi-Specialty
No	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207T00000X	Allopathic & Osteopathic Physicians	Neurological Surgery		Group - Multi-Specialty
No	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Multi-Specialty
No	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty
No	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	208000000X	Allopathic & Osteopathic Physicians	Pediatrics		Group - Multi-Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Multi-Specialty
No	208800000X	Allopathic & Osteopathic Physicians	Urology		Group - Multi-Specialty
No	213E00000X	Podiatric Medicine & Surgery Service Providers	Podiatrist		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	367A00000X	Physician Assistants & Advanced Practice Nursing Providers	Advanced Practice Midwife		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CA	CA118585	Medicare PIN
CA	ZZZ25515Z	Medicare PIN
CA	ZZZ13357Z	Medicare PIN
CA	ZZZ00904Z	Medicare PIN
CA	ZZZ02100Z	Medicare PIN
CA	ZZZ03345Z	Medicare PIN
CA	ZZZ03348Z	Medicare PIN
CA	ZZZ03370Z	Medicare PIN
CA	ZZZ00740Z	Medicare PIN
CA	ZZZ02125Z	Medicare PIN
CA	ZZZ02739Z	Medicare PIN
CA	ZZZ03362Z	Medicare PIN
CA	ZZZ00511Z	Medicare PIN
CA	ZZZ00606Z	Medicare PIN
CA	ZZZ12667Z	Medicare PIN
CA	ZZZ00592Z	Medicare PIN
CA	ZZZ03354Z	Medicare PIN
CA	ZZZ13316Z	Medicare PIN
CA	ZZZ25515Z	Medicare PIN