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Organization

PRIME HEALTHCARE SERVICES - SHERMAN OAKS, LLC

Active
Other names
Sherman Oaks Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
PREM REDDY MD, FACC, FCCP (CHAIRMAN/PRES/CEO)
(909) 235-4400
Entity
Organization

Contact information

Practice address
4929 VAN NUYS BLVD., SHERMAN OAKS, CA 91403-1702
(818) 981-7111
(818) 501-6430
Mailing address
3300 E GUASTI RD, 3RD FLOOR, ONTARIO, CA 91761-8655
(909) 235-4400
(909) 235-4419

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
930000149
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HSC301141
CA
05
HSC30114I
CA
05
HSP301141
CA
05
HSP30114I
CA
05
HSP401141
CA
05
HSP40114I
CA
01
ZZZA1966Z
BLUE SHIELD
CA
Enumeration date
08/30/2006
Last updated
01/14/2014
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