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Organization

ST. JUDE HOSPITAL, INC.

Active
Other names
St. Jude Neighborhood Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARRY ROSS RN (VICE PRESIDENT, HEALTHY COMMUNITIES)
(714) 446-5100
Entity
Organization

Contact information

Practice address
731 SOUTH HIGHLAND AVENUE, FULLERTON, CA 92832
(714) 446-5100
Mailing address
731 SOUTH HIGHLAND AVENUE, FULLERTON, CA 92832
(714) 446-5100

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CMM71168F
CA
Enumeration date
04/17/2007
Last updated
02/27/2008
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