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Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Parent organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Other names
Providence Holy Cross Trauma Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
15031 RINALDI STREET, MISSION HILLS, CA 91345-1207
(818) 365-8051
(818) 898-4569
Mailing address
15031 RINALDI STREET, MISSION HILLS, CA 91345-1207
(818) 365-8051
(818) 898-4569
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
CA
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101520
—
CA
Enumeration date
05/29/2007
Last updated
05/09/2025
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