Organization Name: | COMMUNITY MEMORIAL HEALTH SYSTEM |
NPI Number: | 1467663492 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY WILDE (CEO) |
Mailing Address: | 242 E Harvard Blvd Suite C Santa Paula |
State: | CA US |
Postal Code: | 930603372 |
Phone Number: | 8055259595 |
Fax Number: | 8055256667 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |