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Organization
DIGNITY HEALTH MEDICAL FOUNDATION
Active
Organization
DIGNITY HEALTH MEDICAL FOUNDATION
Active
Parent organization
DIGNITY HEALTH MEDICAL FOUNDATION
Other names
Mercy Imaging Centers, a service of Dignity Health Medical Foundation
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH MEDICAL FOUNDATION
Authorized official
THERESA M HYLEN (CHIEF FINANCIAL OFFICER)
(916) 851-2559
Entity
Organization
Contact information
Practice address
2110 PROFESSIONAL DR, SUITE 190, ROSEVILLE, CA 95661-3752
(916) 787-0404
(916) 787-0434
Mailing address
3000 Q ST, SACRAMENTO, CA 95816-7058
(916) 733-5701
(916) 733-3401
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR001137J
MEDI-CAL
CA
01
—
ZZZ25297Z
BLUE SHIELD
CA
Enumeration date
07/03/2006
Last updated
11/18/2020
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