Organization
DIGNITY HEALTH MEDICAL FOUNDATION
Active
Parent organization
DIGNITY HEALTH MEDICAL FOUNDATION
Other names
Dignity Health Medical Group - Dominican, a service of Dignity Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH MEDICAL FOUNDATION
Authorized official
THERESA M HYLEN (CHIEF FINANCIAL OFFICER)
(916) 851-2559
Entity
Organization
Contact information
Practice address
13350 BIG BASIN WAY, BOULDER CREEK, CA 95006-9237
(831) 338-2767
(831) 338-2767
Mailing address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-5701
(916) 733-3401
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091683
—
CA
01
—
ZZZ50290Z
BSCA
—
Enumeration date
06/21/2007
Last updated
11/18/2020
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