Organization · Type 2 NPI

Sutter West Bay Hospitals

Rural Health Clinic/Center · Upper Lake, CA

NPI number 1629301775 Active

Practice location

750 Old Lucerne Road
Upper Lake, CA 95485-0000

Call (707) 275-9066 Map

Fax (707) 275-9070

Mailing address

PO Box 742412
Los Angeles, CA 90074-2412

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	110000094 (CA)

Rural Health Clinic/Center: Definition to come...

NPI record

NPI: 1629301775
Entity type: Organization (Type 2)
Issued: Sep 8, 2009
Last updated: Jan 20, 2022
Status: Active

Other names

<unavail>
Sutter Lakeside Community Health Center · doing business as
Sutter Lakeside Community Health Center · doing business as

Authorized official

Mr. Brian Trent Hunter
VP Shared Services
(916) 297-8555

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1629301775

Sutter West Bay Hospitals's National Provider Identifier is 1629301775, issued on Sep 8, 2009. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Upper Lake, CA. The record was last updated on Jan 20, 2022.