Basic Information
| Provider Information | |||||||||
| NPI: | 1871261065 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIH HEALTH DOWNEY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11500 BROOKSHIRE AVE | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902414917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629045000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11500 BROOKSHIRE AVE | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902414917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629045000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2021 | ||||||||
| LastUpdateDate: | 09/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | PONCE (AKA CARLSON) | ||||||||
| AuthorizedOfficialFirstName: | SUSANNE (SUE) | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | SPECIAL PROJECTS | ||||||||
| AuthorizedOfficialTelephone: | 5626980811 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PIH HEALTH DOWNEY HOSPITAL | ||||||||
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| NPICertificationDate: | 09/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.