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PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA NPI 1689875601


NPI Information

NPI: 1689875601
Provider Name: PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA

Doing Business As: PROVIDENCE HOLY CROSS TRAUMA CENTER

Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
15031 RINALDI STREET
MISSION HILLS, CA
ZIP 91345
Phone: (818) 365-8051
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PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA is an emergency medicine in Mission Hills, CA. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA NPI is 1689875601. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Providence Holy Cross Trauma Center.

The provider's business location address is:

15031 RINALDI STREET
MISSION HILLS, CA
ZIP 91345-207
Phone: (818) 365-8051
Fax: (818) 898-4569

The provider's authorized official is Donald W Anderson .
The authorized official title is Assistant Secretary For Enrollment and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 5/29/2007 and was last updated on 10/6/2021.


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
1207P00000XEmergency MedicineCALIFORNIANo
2207P00000XEmergency MedicineYes

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
1GR0101520MEDICAIDCALIFORNIA

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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