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Organization
ST VINCENT HEALTHCARE LLC
Active
Organization
ST VINCENT HEALTHCARE LLC
Active
Other names
ST VINCENT HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CIPRIANO BAUTISTA ADMINISTRATOR (ADMINISTRATOR/MEMBER)
(626) 398-8182
Entity
Organization
Contact information
Practice address
1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
(626) 398-8182
(626) 398-0473
Mailing address
1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
(626) 398-8182
(626) 398-0473
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05773J
—
CA
Enumeration date
04/28/2010
Last updated
04/23/2014
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