Basic Information
| Provider Information | |||||||||
| NPI: | 1063495190 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2975 SYCAMORE DR | ||||||||
| Address2: | |||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930651201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059556000 | ||||||||
| FaxNumber: | 8055260837 | ||||||||
| Practice Location | |||||||||
| Address1: | 2975 SYCAMORE DR | ||||||||
| Address2: | |||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930651201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059556000 | ||||||||
| FaxNumber: | 8055260837 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 06/10/2009 | ||||||||
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| AuthorizedOfficialLastName: | BEAMAN | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VP FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8059556202 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ADVENTIST HEALTH SYSTEM/WEST | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 050000216 | CA | Y | Hospitals | General Acute Care Hospital |
No ID Information.