Basic Information
| Provider Information | |||||||||
| NPI: | 1811099674 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALHAMBRA HOSPITAL MEDICAL CENTER, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 S RAYMOND AVE | ||||||||
| Address2: | |||||||||
| City: | ALHAMBRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 918013166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264577938 | ||||||||
| FaxNumber: | 6264577908 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 S RAYMOND AVE | ||||||||
| Address2: | |||||||||
| City: | ALHAMBRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 918013166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264577938 | ||||||||
| FaxNumber: | 6264577908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 02/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | MARSH | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6264577938 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 9500005 | CA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | ZZZC1901Z | 01 | CA | BLUE SHIELD OF CA | OTHER |