Organization Name: | MARK TWAIN ST. JOSEPH'S HOSPITAL |
NPI Number: | 1285936807 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROY SHELDEN (DIRECTOR OF MEDICAL STAFF) |
Mailing Address: | 1919 Vista Del Lago Valley Springs |
State: | CA US |
Postal Code: | 95252 |
Phone Number: | 2097729538 |
Fax Number: | |
NPI Enumeration Date: | 12/02/2010 |
NPI Last Update Date: | 12/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 19190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |