Healthcare Provider Details

I. General information

NPI: 1891062386
Provider Name (Legal Business Name): EMANUEL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 DELBON AVE
TURLOCK CA
95382-2016
US

IV. Provider business mailing address

99 E HARRISON AVE
LATROBE PA
15650-3113
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-4200
  • Fax:
Mailing address:
  • Phone: 559-259-2875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberRN482313
License Number StateCA

VIII. Authorized Official

Name: MS. ANGELINA HUBERT
Title or Position: NURSE ANESTHESTIST
Credential: SRNA
Phone: 559-259-2875