Provider Demographics
NPI:1982480059
Name:SUTTER BAY MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:SUTTER BAY MEDICAL FOUNDATION
Other - Org Name:PALO ALTO MEDICAL FOUNDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SH VP, QUALITY, SAFETY, PATIENT EDU
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 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:795 EL CAMINO REAL
Practice Address - Street 2:LEE BUILDING
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2302
Practice Address - Country:US
Practice Address - Phone:650-934-3542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALO ALTO MEDICAL FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-05
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies