Healthcare Provider Details

I. General information

NPI: 1164514287
Provider Name (Legal Business Name): EMANUEL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N OLIVE AVE
TURLOCK CA
95382-2568
US

IV. Provider business mailing address

PO BOX 819005
TURLOCK CA
95381-9005
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-4200
  • Fax: 209-664-5007
Mailing address:
  • Phone: 209-667-4200
  • Fax: 209-664-5007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number030000035
License Number StateCA

VIII. Authorized Official

Name: DAVID A NEAPOLITAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 209-664-5000