=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275576381
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SADDLEBACK MEMORIAL MEDICAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2006
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24451 HEALTH CENTER DR
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-837-4500
-----------------------------------------------------
Fax | 949-452-3460
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24451 HEALTH CENTER DR
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653-3689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-837-4500
-----------------------------------------------------
Fax | 949-452-3460
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF COMPLIANCE OFFICER
-----------------------------------------------------
Name | CHRIS FINCH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-377-3218
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 060000166
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------