Organization
ST VINCENT HEALTHCARE LLC
Active
Other names
ST VINCENT HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CIPRIANO BAUTISTA ADMINISTRATOR (ADMINISTRATOR/MEMBER)
(626) 398-8182
Entity
Organization
Contact information
Practice address
1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
(626) 398-8182
(626) 398-0473
Mailing address
1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
(626) 398-8182
(626) 398-0473
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05773J
—
CA
Enumeration date
04/28/2010
Last updated
04/23/2014
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