Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
St. Mary's Department of Medicine Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
ERIC BRETTNER (CHIEF FINANCIAL OFFICER)
(415) 750-5726
Entity
Organization
Contact information
Practice address
450 STANYAN ST, SAN FRANCISCO, CA 94117-1079
(415) 668-1000
(415) 750-5899
Mailing address
2235 HAYES ST, 5TH FLOOR, SAN FRANCISCO, CA 94117-1012
(415) 750-5500
(415) 750-5619
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
220000071
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721561126
IRS - SP TAX ID
—
05
—
GR0050760
—
CA
01
—
ZZZ05047Z
BLUE SHIELD OF CA
—
Enumeration date
04/10/2007
Last updated
09/23/2013
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