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
3555 ROUND BARN CIR, SANTA ROSA, CA 95403-1757
(707) 528-1050
(707) 525-3874
Mailing address
279 IMPERIAL HWY, SUITE 730, FULLERTON, CA 92835-1041
(714) 449-4841
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6852510004
NSC
CA
Enumeration date
01/02/2015
Last updated
06/11/2015
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