Sutter Lakeside Hospital – Rural Acute Care Hospital

Key facts

NPI: 1063407229
Entity type: Organization (NPI type 2)
Primary specialty: Rural Acute Care Hospital 282NR1301X
License: 010000118 (CA)
Legal business name: SUTTER LAKESIDE HOSPITAL
Practice address: 5176 Hill Rd E
Lakeport, CA 95453-6300
Phone: (707) 262-5181
Fax: (707) 262-5006
NPI assigned: Sep 14, 2005
Organization subpart: No

Authorized official

Name: Mrs. Kelly Mather, CEO
Title: Ceo
Phone: (707) 262-5001

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Bruce David Deas, MD Internal Medicine Physician · Lakeport, CA · NPI 1639189715

NPD (past)

National Provider Directory

Locations

5132 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Rural Acute Care Hospital	282NR1301X	010000118	CA	Yes

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453-6300

Mailing address

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone (707) 262-5181

Other identifiers

Identifier	Type	State	Issuer
HSP13994F	Other		HAP
ZZZC1701Z	Other		BLUE SHIELD
HSP40476F	Medicaid	CA
050476	Other	CA	MEDICARE PROVIDER NUMBER
CGP127375	Other	CA	CHILDREN SERVICES
050476	Other		BLUE CROSS
C083612	Other		CHAMPVA
ZZR00476F	Medicaid	CA

Other providers in Lakeport, CA

All providers in Lakeport, CA · Rural Acute Care Hospital in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.