SUTTER WEST BAY MEDICAL FOUNDATION NPI 1346575073

NPI Information

  • NPI: 1346575073
  • Provider Name: SUTTER WEST BAY MEDICAL FOUNDATION
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: SUTTER PACIFIC MEDICAL FOUNDATION
  • CLIA Number: 05D0943579
  • Address: 3883 AIRWAY DRIVE
    SUITE 120
    SANTA ROSA, CA
    ZIP 95403
  • Phone: (707) 521-8966

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NPI Details

SUTTER WEST BAY MEDICAL FOUNDATION is a family medicine in Santa Rosa, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SUTTER WEST BAY MEDICAL FOUNDATION NPI is 1346575073. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sutter Pacific Medical Foundation.

The provider's business location address is:

3883 AIRWAY DRIVE
SUITE 120
SANTA ROSA, CA
ZIP 95403-678
Phone: (707) 521-8966
Fax: (707) 523-1301

The provider's authorized official is John B. Gates .
The authorized official title is Chief Financial Officer and has the following contact phone number 41560007771.

The CLIA number assigned to this NPI record is 05D0943579 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/14/2009 and was last updated on 5/21/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineNo
2207R00000XInternal MedicineNo
3207V00000XObstetrics & GynecologyNo
4207X00000XOrthopaedic SurgeryNo
5208000000XPediatricsNo
6208600000XSurgeryNo
7208D00000XGeneral PracticeNo
8213E00000XPodiatristNo
9225100000XPhysical TherapistNo
10247100000XRadiologic TechnologistNo
11291U00000XClinical Medical LaboratoryNo
12363A00000XPhysician AssistantNo
13363L00000XNurse PractitionerNo
14367A00000XAdvanced Practice MidwifeNo
15207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CO467AMEDICARE OSCAR/CERTIFICATION
2GR00055421MEDICAIDCALIFORNIA
3GR0091420MEDICAIDCALIFORNIA
4GR0055425MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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