Healthcare Provider Details

I. General information

NPI: 1922456458
Provider Name (Legal Business Name): SETON MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SULLIVAN AVE
DALY CITY CA
94015-2200
US

IV. Provider business mailing address

PO BOX 742974
LOS ANGELES CA
90074-2974
US

V. Phone/Fax

Practice location:
  • Phone: 650-992-4000
  • Fax:
Mailing address:
  • Phone: 650-992-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number220000026
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number220000026
License Number StateCA

VIII. Authorized Official

Name: JOHN FERRELLI
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 650-991-6491