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General NPI Number Information
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NPI Number | 1629749577
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH GROUP
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 2420 FENTON ST STE 100
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City | CHULA VISTA
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State | CA
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Zip | 91914-3516
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Country | US
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Telephone | 619-422-0422
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Fax | 619-476-3836
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Provider Business Mailing Address
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Address Line | 2420 FENTON ST STE 100
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City | CHULA VISTA
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State | CA
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Zip | 91914-3516
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Country | US
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Telephone | 619-422-0422
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Fax | 619-476-3836
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | NORMA DIAZ
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Credential |
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Telephone | 619-498-6416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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