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Organization
ST JUDE HOSPITAL INC
Active
Organization
ST JUDE HOSPITAL INC
Active
Other names
Providence St. Jude Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(714) 871-3280
(714) 870-3525
Mailing address
2767 E IMPERIAL HWY, SECOND FLOOR, BREA, CA 92821-6713
(714) 870-3510
(714) 870-3525
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
060000173
CA
Other
Enumeration date
05/29/2007
Last updated
05/09/2025
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