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SUTTER WEST BAY MEDICAL FOUNDATION NPI 1720212012


NPI Information

NPI: 1720212012
Provider Name: SUTTER WEST BAY MEDICAL FOUNDATION

Doing Business As: SUTTER PACIFIC MEDICAL FOUNDATION

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
3000 COLBY ST
#205
BERKELEY, CA
ZIP 94705
Phone: (510) 776-4143
Get Directions

SUTTER WEST BAY MEDICAL FOUNDATION is a pediatrics in Berkeley, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SUTTER WEST BAY MEDICAL FOUNDATION NPI is 1720212012. 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:

3000 COLBY ST
#205
BERKELEY, CA
ZIP 94705-083
Phone: (510) 776-4143
Fax: (510) 486-1478

The provider's authorized official is John Gates .
The authorized official title is Rcfo and has the following contact phone number (415) 600-7755.

The enumeration date for this NPI number is 5/14/2009 and was last updated on 9/25/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RI0008XInternal MedicineHepatologyNo
2207RN0300XInternal MedicineNephrologyNo
3207W00000XOphthalmologyNo
42080P0205XPediatricsPediatric EndocrinologyNo
5208000000XPediatricsYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BF336AMEDICARE PINCALIFORNIA

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: 4/28/2024

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