Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Other names
Providence Saint Joseph Medical Center
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
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 847-3022
(310) 303-7575
Mailing address
PO BOX 31001-3017, PASADENA, CA 91110-3017
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050235
BLUE CROSS PROV#
CA
05
—
HSC30235G
—
CA
05
—
ZZT30235G
—
CA
05
—
ZZT40235G
—
CA
01
—
ZZZA1901Z
BLUE SHIELD PROV#
CA
Enumeration date
07/10/2006
Last updated
05/09/2025
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