Basic Information
| Provider Information | |||||||||
| NPI: | 1497077911 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GATEWAY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1891 EFFRIE STREET | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236442000 | ||||||||
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| Address1: | 1891 EFFRIE STREET | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236442000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2010 | ||||||||
| LastUpdateDate: | 02/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | DESANTIAGO | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
| AuthorizedOfficialMiddleName: | ALICIA | ||||||||
| AuthorizedOfficialTitleorPosition: | PARENT PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3235035764 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | GATEWAY HOSPITAL | ||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | CA | Y | Hospitals | Psychiatric Hospital |
No ID Information.