Provider Demographics
NPI:1215963772
Name:SUTTER NORTH MEDICAL FOUNDATION
Entity type:Organization
Organization Name:SUTTER NORTH MEDICAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:YAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-749-3330
Mailing Address - Street 1:969 PLUMAS ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4011
Mailing Address - Country:US
Mailing Address - Phone:530-749-3434
Mailing Address - Fax:530-749-3348
Practice Address - Street 1:480 PLUMAS BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5005
Practice Address - Country:US
Practice Address - Phone:530-749-3409
Practice Address - Fax:530-749-3551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ38741ZMedicare ID - Type Unspecified
CAZZZ01741ZMedicare ID - Type Unspecified
CAZZZ14397ZMedicare ID - Type Unspecified
CAZZZ17570ZMedicare ID - Type Unspecified
CAZZZ01046ZMedicare ID - Type Unspecified
CAZZZ15892ZMedicare ID - Type Unspecified
CAZZZ38735ZMedicare ID - Type Unspecified
CAZZZ03071ZMedicare ID - Type Unspecified
CAZZZ17439ZMedicare ID - Type Unspecified
CAZZZ21006ZMedicare ID - Type Unspecified
CAZZZ23963ZMedicare ID - Type Unspecified
CAZZZ38736ZMedicare ID - Type Unspecified
CAZZZ38740ZMedicare ID - Type Unspecified