Healthcare Provider Details

I. General information

NPI: 1891938122
Provider Name (Legal Business Name): AHMC ANAHEIM REGIONAL MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

55 S RAYMOND AVE STE 105
ALHAMBRA CA
91801
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax: 714-999-6027
Mailing address:
  • Phone: 626-457-7938
  • Fax: 626-457-7908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number060000080
License Number StateCA

VIII. Authorized Official

Name: LINDA MARSH
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 626-457-7938