NPIMap

Organization Active NPI

Sutter West Bay Medical Foundation

Doing business as Sutter Pacific Medical Foundation

  • Clinical Medical Laboratory
  • Santa Rosa, CA
National Provider Identifier
1245565977
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SUTTER WEST BAY MEDICAL FOUNDATION
Doing business as
Sutter Pacific Medical Foundation
Practice address
3883 Airway Drive
Suite 202
Santa Rosa, CA 95403-1671
Phone
(707) 521-8900
Fax
(707) 523-1302
NPI assigned
Oct 14, 2009
Last updated
May 21, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SUTTER WEST BAY MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2010

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

Authorized official

Name
Mr. John B. Gates
Title
Chief Financial Officer
Phone
(415) 600-7771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

3883 Airway Drive
Suite 202
Santa Rosa, CA 95403-1671

Mailing address

1700 California Street
Suite 530
San Francisco, CA 94109-4591

Other names 1

  • Sutter Pacific Medical Foundation Doing business as

National Provider Directory

National Provider Directory
Part of
Sutter West Bay Med Found

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1245565977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CALIFORNIA STREET",
            "address_2": "SUITE 530",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DRIVE",
            "address_2": "SUITE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-521-8900",
            "fax_number": "707-523-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER WEST BAY MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER WEST BAY MEDICAL FOUNDATION",
        "enumeration_date": "2009-10-14",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "415-600-7771",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Pacific Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.