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General NPI Number Information
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NPI Number | 1437304391
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Entity Type | Organization
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Legal Business Name | TUSTIN HOSPITAL AND MEDICAL CENTER
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 14662 NEWPORT AVE
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City | TUSTIN
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State | CA
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Zip | 92780-6064
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Country | US
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Telephone | 714-669-5832
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Fax | 714-669-5986
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Provider Business Mailing Address
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Address Line | 14662 NEWPORT AVE
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City | TUSTIN
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State | CA
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Zip | 92780-6064
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Country | US
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Telephone | 714-669-5832
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Fax | 714-669-5986
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Authorized Official
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Title or Position | ASST. DIRECTOR OF PFS
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Name | RONNELL D RICHARD
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Credential |
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Telephone | 714-669-5832
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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 | 555730
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License Number State | CA
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