Organization
ST. JOSEPH HOSPITAL OF ORANGE
Active
Other names
Puente A La Salud Mobile Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN H GARRETT (CHIEF OPERATING OFFICER)
(714) 771-8000
Entity
Organization
Contact information
Practice address
363 S MAIN ST, SUITE 204, ORANGE, CA 92868-3833
(714) 744-8801
(714) 744-8629
Mailing address
363 S MAIN ST, SUITE 204, ORANGE, CA 92868-3833
(714) 744-8801
(714) 744-8629
Taxonomy
Speciality
Code
Description
License number
State
261QM1000X
Migrant Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMM7079OF
MEDI-CAL
CA
01
—
EAP70367F
(EAPC)
CA
01
—
G93665-02
DENTICAL
CA
Enumeration date
05/22/2007
Last updated
08/22/2020
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