Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
HealthCare Clinical Laboratories
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
DOREEN HARTMANN (CHIEF FINANCIAL OFFICER)
(209) 467-6442
Entity
Organization
Contact information
Practice address
2102 N CALIFORNIA ST, STOCKTON, CA 95204-6031
(209) 467-6396
(209) 467-6513
Mailing address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 467-6396
(209) 467-6513
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
CA CLF2633
CA
291U00000X
Clinical Medical Laboratory
Primary
CA CLF2633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300181900
DOL - WORKERS COMP
—
01
—
651191369
IRS - SP TAX ID
—
01
—
651191369952040002
WPS TRICARE
—
05
—
HSP40084G
—
CA
05
—
HSP40084L
—
CA
01
—
ZZZ53996Y
BSCA
—
Enumeration date
04/11/2007
Last updated
09/23/2013
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