Organization
PROVIDENCE SAINT JOHN'S HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-5511
(310) 315-6135
Mailing address
1328 22ND ST, SANTA MONICA, CA 90404-2032
(310) 829-5511
(310) 315-6135
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
930000158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT30290F
—
CA
05
—
ZZT40290F
—
CA
Enumeration date
07/12/2005
Last updated
05/09/2025
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