Healthcare Provider Details

I. General information

NPI: 1346383338
Provider Name (Legal Business Name): DIGNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST
SAN FRANCISCO CA
94117-1079
US

IV. Provider business mailing address

3215 PROSPECT PARK DR
RANCHO CORDOVA CA
95670-6017
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-1000
  • Fax: 415-750-5899
Mailing address:
  • Phone: 916-861-1102
  • Fax: 916-861-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220000071
License Number StateCA

VIII. Authorized Official

Name: ERIC BRETTNER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 415-750-5726