Healthcare Provider Details

I. General information

NPI: 1114339918
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 MARICOPA HWY
OJAI CA
93023-3131
US

IV. Provider business mailing address

1306 MARICOPA HWY
OJAI CA
93023-3131
US

V. Phone/Fax

Practice location:
  • Phone: 805-646-1401
  • Fax:
Mailing address:
  • Phone: 805-646-1401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GARY K WILDE
Title or Position: CEO
Credential:
Phone: 805-652-5036