Healthcare Provider Details

I. General information

NPI: 1144373317
Provider Name (Legal Business Name): PERRIS VALLEY COMMUNITY HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 MEDICAL CENTER DR
PERRIS CA
92571-2638
US

IV. Provider business mailing address

2224 MEDICAL CENTER DR
PERRIS CA
92571-2638
US

V. Phone/Fax

Practice location:
  • Phone: 951-436-3535
  • Fax: 951-436-3536
Mailing address:
  • Phone: 951-436-3535
  • Fax: 951-436-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARC FERRELL
Title or Position: SENIOR VP
Credential:
Phone: 562-715-0974