Sutter Central Valley Hospitals

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

040000177 Issued in CA

Legal business name

SUTTER CENTRAL VALLEY HOSPITALS

Doing business as

Memorial Hospital Los Banos/Rural Health Clinic

Practice address

400 W I St Ste C
Los Banos, CA 93635-3459

Phone

(209) 710-6333

Fax

(209) 827-0554

NPI assigned

Apr 28, 2009

Organization subpart

No

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

Authorized official

Name

John Gates

Title

Cfo Vpba

Phone

(510) 450-7357

Specialties & licenses 1

Addresses

Other names 1

• Memorial Hospital Los Banos/Rural Health Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Sutter Valley Hospitals

  dba Memorial Hospital Los Banos/Rural Health Clinic

  • Rural Health Clinic/Center
  • Los Banos, CA
  • NPI 1487017471

  Sold to, 2017-05-01

  CMS change of ownership

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1528202090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740152",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740152",
            "telephone_number": "855-398-1633",
            "fax_number": "209-569-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W I ST STE C",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353459",
            "telephone_number": "209-710-6333",
            "fax_number": "209-827-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER CENTRAL VALLEY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO VPBA",
        "authorized_official_telephone_number": "510-450-7357"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "040000177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital Los Banos/Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sudanagunta Peraiah MD Inc
• Tristan Dwele Sullivan I
• Yu Sun
• Surgical Affiliates of California
• Sutter Central Valley Hospitals (Memorial Hospital Los Banos)
• Sutter Emergency Medical Associates
• Sutter Valley Hospitals (Sutter Los Banos Rural Health Clinic East)
• Sutter Valley Hospitals (Memorial Hospital Los Banos)
• Sutter Valley Hospitals (Memorial Hospital Los Banos/Rural Health Clinic)
• Sutter Valley Hospitals (Sutter Memorial Hospital Los Banos Outpatient Clinic)

• Rural Health Clinic/Center in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.