| Organization Name: | SUTTER LAKESIDE HOSPITAL |
| NPI Number: | 1063407229 |
| 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: | 7072625181 |
| Fax Number: | 7072625006 |
| NPI Enumeration Date: | 09/14/2005 |
| NPI Last Update Date: | 07/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NR1301X |
| License Number: | 010000118 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Rural |
| Taxonomy Definition: | |