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General NPI Number Information
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NPI Number | 1083664841
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Entity Type | Organization
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Legal Business Name | PIH HEALTH WHITTIER HOSPITAL
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 12291 WASHINGTON BLVD 500
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City | WHITTIER
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State | CA
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Zip | 90606-2500
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Country | US
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Telephone | 562-698-2541
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Fax | 562-698-0010
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Provider Business Mailing Address
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Address Line | PO BOX 1277
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City | WHITTIER
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State | CA
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Zip | 90609-1277
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Country | US
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Telephone | 562-789-5401
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Fax | 562-789-5912
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Authorized Official
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Title or Position | SPECIAL PROJECTS
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Name | SUE R PONCE (AKA CARLSON)
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Credential |
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Telephone | 562-698-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A52601
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License Number State | CA
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