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Organization

DIGNITY HEALTH MEDICAL FOUNDATION

Active
Parent organization
DIGNITY HEALTH MEDICAL FOUNDATION
Other names
Mercy Medical Group, a service of Dignity Health Medical Foundation
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIGNITY HEALTH MEDICAL FOUNDATION
Authorized official
THERESA M HYLEN (CHIEF FINANCIAL OFFICER)
(916) 851-2559
Entity
Organization

Contact information

Practice address
8120 TIMBERLAKE WAY, SACRAMENTO, CA 95823-5412
(916) 681-6000
(916) 681-6135
Mailing address
PO BOX 60000, FILE #72938, SAN FRANCISCO, CA 94160-2938
(916) 733-3397

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0019838
CIGNA
01
195
HEALTH NET
01
476040022
DME SUPPLIER #
01
983
HEALTH NET
05
GR0050151
CA
01
KYR
BLUE CROSS
01
ZZZ43962Z
BLUE SHIELD
Enumeration date
03/16/2007
Last updated
11/18/2020
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