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General NPI Number Information
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NPI Number | 1730526963
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Entity Type | Organization
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Legal Business Name | PRIME HEALTHCARE ANAHEIM, LLC
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 3033 W ORANGE AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-3156
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Country | US
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Telephone | 714-229-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 3033 W ORANGE AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-3156
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Country | US
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Telephone | 714-229-5678
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Fax |
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Authorized Official
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Title or Position | MANAGING ASSOCIATE GENERAL COUNSEL
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Name | CHRISTOPHER DOAN
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Credential |
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Telephone | 310-259-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 060000182
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 060000182
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License Number State | CA
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