Healthcare Provider Details

I. General information

NPI: 1528054632
Provider Name (Legal Business Name): VERDUGO HILLS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 VERDUGO BLVD
GLENDALE CA
91208-1409
US

IV. Provider business mailing address

1812 VERDUGO BLVD
GLENDALE CA
91208-1407
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-7100
  • Fax: 818-790-7100
Mailing address:
  • Phone: 818-790-7100
  • Fax: 818-790-5269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number930000173
License Number StateCA

VIII. Authorized Official

Name: MS. CYNTHIA TROUSDALE
Title or Position: CFO
Credential:
Phone: 818-790-7100