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General NPI Number Information
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NPI Number | 1043456106
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Entity Type | Organization
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Legal Business Name | DIGNITY HEALTH MEDICAL FOUNDATION
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 280 SIERRA COLLEGE DR STE 105
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5763
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Country | US
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Telephone | 530-274-6727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742664
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City | LOS ANGELES
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State | CA
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Zip | 90074-2664
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Country | US
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Telephone | 916-733-5701
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Fax | 916-859-1671
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | THERESA M HYLEN
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Credential |
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Telephone | 916-851-2559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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