=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346232881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AHMC GREATER EL MONTE COMMUNITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2005
-----------------------------------------------------
Last Update Date | 01/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1701 SANTA ANITA AVE
-----------------------------------------------------
City | SOUTH EL MONTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91733-3482
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-579-7777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 SANTA ANITA AVE
-----------------------------------------------------
City | SOUTH EL MONTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91733-3482
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-579-7777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR VICE-PRESIDENT
-----------------------------------------------------
Name | MS. LINDA MARSH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-705-0972
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 930000063
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------