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General NPI Number Information
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NPI Number | 1780843805
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Entity Type | Organization
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Legal Business Name | DIGNITY HEALTH
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 2309 ANTONIO AVE
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City | CAMARILLO
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State | CA
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Zip | 93010-1414
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Country | US
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Telephone | 805-389-5880
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Fax | 805-389-5883
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Provider Business Mailing Address
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Address Line | 2415 ANTONIO AVE
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City | CAMARILLO
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State | CA
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Zip | 93010-1459
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Country | US
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Telephone | 805-389-5115
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Fax | 805-383-7461
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBERT WARDWELL
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Credential |
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Telephone | 805-389-5113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF 2581
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License Number State | CA
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