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General NPI Number Information
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NPI Number | 1144916958
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Entity Type | Organization
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Legal Business Name | CHARTER OAK HOSPITAL
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 1161 E COVINA BLVD
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City | COVINA
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State | CA
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Zip | 91724-1523
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Country | US
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Telephone | 626-966-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 E COVINA BLVD
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City | COVINA
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State | CA
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Zip | 91724-1523
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HOUSE SUPERVISOR
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Name | RONALD CHING
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Credential |
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Telephone | 626-966-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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