Organization
ST JUDE HOSPITAL YORBA LINDA
Active
Other names
ST JOSEPH HERITAGE HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BENNETT (CHIEF OPERATING OFFICER)
(714) 449-4800
Entity
Organization
Contact information
Practice address
100 E VALENCIA MESA DR, SUITE 310, FULLERTON, CA 92835-3813
(714) 446-5200
(714) 446-5524
Mailing address
279 IMPERIAL HWY, SUITE 730, FULLERTON, CA 92835-1041
(714) 449-4841
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
02/02/2011
Last updated
02/02/2011
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