Organization
DIGNITY HEALTH
Active
Other names
San Gabriel Valley Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MORISSETTE (CHIEF FINANCIAL OFFICER)
(858) 275-8112
Entity
Organization
Contact information
Practice address
438 W LAS TUNAS DR, SAN GABRIEL, CA 91776-1216
(858) 275-8112
(779) 803-8118
Mailing address
3215 PROSPECT PARK DR, RANCHO CORDOVA, CA 95670-6017
(858) 275-8112
(779) 803-8118
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
930000041
CA
314000000X
Skilled Nursing Facility
930000041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050132B000000
CMS SECTION 1011
CA
01
—
2065802
AETNA
CA
01
—
651191366
IRS
CA
01
—
651191366917760000
WPS TRICARE
CA
05
—
HSC30132G
—
CA
05
—
LTC55237H
—
CA
05
—
LTC70144F
—
CA
01
—
SGVM
UNIVERSAL
CA
05
—
ZZT30132G
—
CA
05
—
ZZT40132G
—
CA
01
—
ZZZA2013Z
BLUE SHIELD
CA
Enumeration date
01/16/2007
Last updated
07/03/2025
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