Sutter West Bay Medical Foundation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUTTER WEST BAY MEDICAL FOUNDATION

Doing business as

Sutter Pacific Medical Foundation

Practice address

750 Las Gallinas Ave
#210
San Rafael, CA 94903-3438

Phone

(415) 479-7244

Fax

(415) 479-0917

NPI assigned

May 14, 2009

Last updated

Sep 25, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SUTTER WEST BAY MEDICAL FOUNDATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Gates, MD

Title

Rcfo

Phone

(415) 600-7755

Specialties & licenses 5

Addresses

Other names 1

• Sutter Pacific Medical Foundation Doing business as

Part of

Sutter West Bay Medical

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Sutter West Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1104852789
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1124252416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 254947",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958654947",
            "telephone_number": "916-854-6975",
            "fax_number": "916-854-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "#210",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-479-7244",
            "fax_number": "415-479-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER WEST BAY MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER WEST BAY MEDICAL FOUNDATION",
        "enumeration_date": "2009-05-14",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "RCFO",
        "authorized_official_telephone_number": "415-600-7755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Pacific Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunrise II
• Renee Noemie Surcouf, LCSW
• Erica Sutherland, RN FNP
• Abro Sutker, N.D.
• Sutter Bay Medical Foundation (Sutter Pacific Medical Foundation)
• Audre Suzanne, PT
• Suzie Yang, DDS, Inc
• Gloria Sverchek, MFTI
• Frances Svidler, DPM
• Jawana J Swanson, RCP, RRT

• Pediatrics Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.