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General NPI Number Information
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NPI Number | 1134654684
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN GENERAL HOSPITAL
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 500 W HOSPITAL RD
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9693
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Country | US
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Telephone | 209-468-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 108 DUTTON AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-2841
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Country | US
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Telephone | 510-735-4044
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Fax |
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Authorized Official
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Title or Position | SJGH FOUNDATION EXECUTIVE DIRECTOR
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Name | MS. ROB WOOTEN
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Credential |
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Telephone | 209-468-7781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 04003
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License Number State | CA
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