Basic Information
| Provider Information | |||||||||
| NPI: | 1417014275 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY HOSPITAL OF LOS GATOS, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COMMUNITY HOSPITAL OF LOS GATOS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | FILE 57434 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900747434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095782513 | ||||||||
| FaxNumber: | 4088664003 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 POLLARD RD | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950321438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083786131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 03/16/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ARMIN | ||||||||
| AuthorizedOfficialFirstName: | CRAIG | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF GOVT PROGRAMS, TENET | ||||||||
| AuthorizedOfficialTelephone: | 8184362267 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COMMUNITY HOSPITAL OF LOS GATOS, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273Y00000X | 070000025 | CA | Y | Hospital Units | Rehabilitation Unit |
No ID Information.