Organization Name: | ST. CHARLES HOSPITAL CORP |
NPI Number: | 1326450297 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KERI LOGAN (DIRECTOR:DENTAL RESIDENCY PROGRAM) |
Mailing Address: | 9830 Amanita Ave Tujunga |
State: | CA US |
Postal Code: | 910422917 |
Phone Number: | 8183096898 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2014 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |