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General NPI Number Information
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NPI Number | 1932366614
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Entity Type | Organization
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Legal Business Name | BLOSS MEMORIAL DISTRICT HOSPITAL CASTLE FAMILY HLTH CTR & ADULT DAYCAR
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 3605 HOSPITAL RD
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City | ATWATER
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State | CA
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Zip | 95301-5173
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Country | US
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Telephone | 209-381-2000
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Fax | 209-726-0278
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Provider Business Mailing Address
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Address Line | 3605 HOSPITAL RD STE H
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City | ATWATER
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State | CA
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Zip | 95301-5173
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Country | US
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Telephone | 209-381-2000
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Fax | 209-726-0278
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Authorized Official
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Title or Position | CEO
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Name | MR. EDWARD HILARIO LUJAN
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Credential |
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Telephone | 209-381-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A81776
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G60458
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C50290
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License Number State | CA
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