Organization
ST JUDE HOSPITAL YORBA LINDA
Active
Other names
St Joseph Heritage Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
BOB JUST (CHIEF OPERATING OFFICER)
(707) 303-8355
Entity
Organization
Contact information
Practice address
108 LYNCH CREEK WAY, SUITE 3, PETALUMA, CA 94954-2357
(707) 763-7403
(707) 789-0900
Mailing address
279 IMPERIAL HWY, SUITE 730, FULLERTON, CA 92835-1041
(714) 449-4841
(714) 449-4956
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6852510005
NSC
CA
Enumeration date
12/23/2014
Last updated
07/14/2015
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