Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
Kaiser Foundation Hospital Manteca
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH FRIBERG (SR. VP/AREA MANAGER)
(209) 735-4146
Entity
Organization
Contact information
Practice address
1777 W YOSEMITE AVE, MANTECA, CA 95337-5130
(209) 825-3700
Mailing address
1777 W YOSEMITE AVE, MANTECA, CA 95337-5130
(209) 825-3700
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
030000393
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050748B000000
SECTION 1011-DHS
CA
01
—
50748
BLUE CROSS OF CA
CA
05
—
HSP30695
—
CA
05
—
HSP40695H
—
CA
Enumeration date
11/20/2006
Last updated
04/14/2021
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