Healthcare Provider Details

I. General information

NPI: 1013989714
Provider Name (Legal Business Name): PASADENA HOSPITAL ASSOCIATION, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5555
  • Fax: 626-397-2995
Mailing address:
  • Phone: 626-397-5555
  • Fax: 626-397-2995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number930000372
License Number StateCA

VIII. Authorized Official

Name: LORI J. MORGAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 626-397-5555