MEDICARE: DIGNITY HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1528560794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNITY HEALTH

Provider Business Mailing Address
First Line	:	1400 S GRAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3048
Country	:	US
Telephone Number	:	213-742-6250
Fax Number	:	213-742-6312

Provider Business Practice Location Address
First Line	:	1211 S HOBART BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-3113
Country	:	US
Telephone Number	:	323-734-4823
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	REBECCA CHENG
Credential	:
Telephone Number	:	213-742-5910

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	03/05/2018

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Directions to “DIGNITY HEALTH ” Practice Location

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