Healthcare Provider Details

I. General information

NPI: 1265433551
Provider Name (Legal Business Name): PIH HEALTH DOWNEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 BROOKSHIRE AVE
DOWNEY CA
90241-4917
US

IV. Provider business mailing address

11500 BROOKSHIRE AVE P.O. BOX 7010
DOWNEY CA
90241-4917
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-5000
  • Fax: 562-904-5164
Mailing address:
  • Phone: 562-904-5000
  • Fax: 562-904-5164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000043
License Number StateCA

VIII. Authorized Official

Name: SUE R PONCE (AKA CARLSON)
Title or Position: SPECIAL PROJECTS
Credential:
Phone: 562-698-0811