Healthcare Provider Details

I. General information

NPI: 1467672667
Provider Name (Legal Business Name): HUNTINGTON MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD PHARMACY
PASADENA CA
91105-3010
US

IV. Provider business mailing address

100 W. CALIFORNIA BOULEVARD
PASADENA CA
91109-7013
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5176
  • Fax: 626-397-2945
Mailing address:
  • Phone: 626-397-5176
  • Fax: 626-397-2945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. STEVEN RALPH
Title or Position: CEO
Credential:
Phone: 626-397-5555