ST JUDE HOSPITAL YORBA LINDA NPI 1629374053

NPI Information

NPI: 1629374053
Provider Name: ST JUDE HOSPITAL YORBA LINDA

Doing Business As: ST JOSEPH HERITAGE HEALTHCARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1514 VALLEY VISTA DR
DIAMOND BAR, CA
ZIP 91765
Phone: (909) 860-1144
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ST JUDE HOSPITAL YORBA LINDA is a family medicine in Diamond Bar, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ST JUDE HOSPITAL YORBA LINDA NPI is 1629374053. The provider is registered as an organization entity type.
The provider Is Doing Business As St Joseph Heritage Healthcare.

The provider's business location address is:

1514 VALLEY VISTA DR
DIAMOND BAR, CA
ZIP 91765-929
Phone: (909) 860-1144
Fax: (909) 860-8307

The provider's authorized official is John Bennett .
The authorized official title is Chief Operating Officer and has the following contact phone number (714) 449-4800.

The enumeration date for this NPI number is 2/2/2011 and was last updated on 2/2/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	207Q00000X	Family Medicine				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W13074F	MEDICARE PIN	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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