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Organization
ST JUDE HOSPITAL YORBA LINDA
Active
Organization
ST JUDE HOSPITAL YORBA LINDA
Active
Other names
St Joseph Heritage Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
BOB JUST (CHIEF OPERATING OFFICER)
(707) 303-8355
Entity
Organization
Contact information
Practice address
108 LYNCH CREEK WAY, SUITE 3, PETALUMA, CA 94954-2357
(707) 763-7403
(707) 789-0900
Mailing address
279 IMPERIAL HWY, SUITE 730, FULLERTON, CA 92835-1041
(714) 449-4841
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6852510005
NSC
CA
Enumeration date
12/23/2014
Last updated
07/14/2015
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