Organization
DIGNITY HEALTH
Active
Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
St. Mary Medical Center C.A.R.E. Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
RACHEL SMITH (CHIEF FINANCIAL OFFICER (INTERIM))
(562) 491-9929
Entity
Organization
Contact information
Practice address
1043 ELM AVE, LONG BEACH, CA 90813-3271
(562) 624-4900
(562) 491-9128
Mailing address
1043 ELM AVE, SUITE 300, LONG BEACH, CA 90813-3271
(562) 624-4906
(562) 624-4960
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
930000012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022013
AETNA
—
01
—
870692255
IRS
CA
05
—
AYD000290
—
CA
05
—
ZZT40191H
—
CA
01
—
ZZZA0191Z
BLUE SHIELD
CA
Enumeration date
03/21/2007
Last updated
09/23/2013
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