Organization Name: | GROSSMONT HOSPITAL CORPORATION |
NPI Number: | 1467810952 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT EVANS (CEO) |
Mailing Address: | 3850 Valley Vista Rd Bonita |
State: | CA US |
Postal Code: | 919021206 |
Phone Number: | 6194346816 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2016 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 550003289 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |