Healthcare Provider Details

I. General information

NPI: 1639797855
Provider Name (Legal Business Name): AHMC SETON MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SULLIVAN AVE
DALY CITY CA
94015-2200
US

IV. Provider business mailing address

55 S RAYMOND AVE STE 105
ALHAMBRA CA
91801-7101
US

V. Phone/Fax

Practice location:
  • Phone: 650-992-4400
  • Fax:
Mailing address:
  • Phone: 626-705-0972
  • Fax: 626-457-7489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: LINDA MARSH
Title or Position: SENIOR EXECUTIVE VICE PRESIDENT
Credential:
Phone: 626-705-0972