| Organization Name: | SUTTER LAKESIDE HOSPITAL |
| NPI Number: | 1053495879 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY MATHER (CEO) |
| Mailing Address: | 5176 Hill Rd E Lakeport |
| State: | CA US |
| Postal Code: | 954536300 |
| Phone Number: | 7072625001 |
| Fax Number: | 7072625006 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |