Organization Name: | COMMUNITY MEMORIAL HEALTH SYSTEM |
NPI Number: | 1659656775 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY K WILDE (CEO) |
Mailing Address: | 321 E Port Hueneme Rd Port Hueneme |
State: | CA US |
Postal Code: | 930413222 |
Phone Number: | 8056524267 |
Fax Number: | 8056524288 |
NPI Enumeration Date: | 10/20/2011 |
NPI Last Update Date: | 01/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |