Healthcare Provider Details

I. General information

NPI: 1679759815
Provider Name (Legal Business Name): HUNTINGTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MARION AVE 2
PASADENA CA
91106-2044
US

IV. Provider business mailing address

75 MARION AVE 2
PASADENA CA
91106-2044
US

V. Phone/Fax

Practice location:
  • Phone: 858-729-4590
  • Fax:
Mailing address:
  • Phone: 858-729-4590
  • Fax:

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: DR. ANTHONY KOERNER
Title or Position: PROGRAM DIRECTOR
Credential: M.D
Phone: 626-397-5000