Provider Demographics
NPI:1730238007
Name:SUTTER BAY HOSPITALS
Entity type:Organization
Organization Name:SUTTER BAY HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
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 742412
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2412
Mailing Address - Country:US
Mailing Address - Phone:855-398-1633
Mailing Address - Fax:
Practice Address - Street 1:3555 CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4403
Practice Address - Country:US
Practice Address - Phone:415-600-7180
Practice Address - Fax:415-600-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X, 282E00000X
CA220000070282E00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSC00055GMedicaid
CALTC55243GMedicaid
CAHSP40055FMedicaid
CALTC55243FMedicaid
CALTC70042FMedicaid
CAHSC000055GMedicaid
CAHSC00055FMedicaid
CAHSP40055GMedicaid
CAZZR00055FMedicaid
CA050055Medicare Oscar/Certification
CA555243Medicare Oscar/Certification
55-5243Medicare PIN
CALTC55243GMedicaid