SL
Medical Clinic
SUTTER LAKESIDE MEDICAL PRACTICE
987 PARALLEL DR, SUITE C, LAKEPORT, CA 95453
Source updated 2026-10-16. Source-listed location, not a NursingHomes.io endorsement. Confirm operating status, care availability, and services directly.
Official provider information
- CCN
- 553994
- LTC
- NON-LTC
- NPI
- 1770816829
- ZIP
- 95453
- id
- 2250
- CITY
- LAKEPORT
- FLAG
- Not reported
- ZIP9
- Not reported
- rank
- 0.057308756
- AO CD
- Not reported
- FACID
- 110000840
- DEEMED
- 0
- T18 19
- Not reported
- ADDRESS
- 987 PARALLEL DR, SUITE C
- AO NAME
- Not reported
- FACNAME
- SUTTER LAKESIDE MEDICAL PRACTICE
- FAC FDR
- PRIMARY CARE CLINIC
- HCAI ID
- Not reported
- CAPACITY
- 0
- LATITUDE
- 39.035295
- LOCATION
- (-122.9277195,39.035295)
- DATA DATE
- 2026-10-16T00:00:00
- ISFACMAIN
- N
- LONGITUDE
- -122.9277195
- CCLHO CODE
- 17
- CCLHO NAME
- LAKE
- START DATE
- 28APR1978
- TRAUMA CTR
- Not reported
- ASPEN FACID
- CA110000840
- COUNTY CODE
- 160
- COUNTY NAME
- LAKE
- TERMINAT SW
- Not reported
- AO TRMNTN DT
- Not reported
- DMG EFCTV DT
- Not reported
- PARENT FACID
- 110000019
- TYPE OF CARE
- Not reported
- APPROVAL DATE
- 2014-09-18T00:00:00
- BUSINESS NAME
- SUTTER BAY HOSPITALS
- DISTRICT NAME
- SANTA ROSA
- FAC TYPE CODE
- RHC/OP
- LICENSE NUMBER
- 110000094
- TRAUMA PED CTR
- Not reported
- DISTRICT NUMBER
- 11
- FIPS COUNTY CODE
- 6033
- LICENSED CERTIFIED
- LICENSED AND CERTIFIED
- PARTICIPATION DATE
- 1994-10-13T00:00:00
- CONTACT PHONE NUMBER
- Not reported
- FAC STATUS TYPE CODE
- OPEN
- INITIAL LICENSE DATE
- 1978-04-28T00:00:00
- BIRTHING FACILITY FLAG
- Not reported
- CAN BE DEEMED FAC TYPE
- Y
- LICENSE EFFECTIVE DATE
- 2026-08-05T00:00:00
- ENTITY TYPE DESCRIPTION
- NONPROFIT CORP
- LICENSE EXPIRATION DATE
- 2026-12-31T00:00:00
- CRITICAl ACCESS HOSPITAL
- Not reported
- CAN BE CERTIFIED FAC TYPE
- Y
- LICENSE STATUS DESCRIPTION
- ACTIVE
- FAC FAC RELATIONSHIP TYPE CODE
- OTHER CERTIFIABLE PART
COMMUNITY EXPERIENCE
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