Provider Demographics
| NPI: | 1154467181 |
|---|---|
| Name: | THE HUNTINGTON MEDICAL FOUNDATION |
| Entity type: | Organization |
| Organization Name: | THE HUNTINGTON MEDICAL FOUNDATION |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR OF REVENUE CYCLE |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KENDRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WILLIAMS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 626-397-8384 |
| Mailing Address - Street 1: | 100 W CALIFORNIA BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PASADENA |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 91105-3010 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 626-397-8335 |
| Mailing Address - Fax: | 626-397-8337 |
| Practice Address - Street 1: | 100 W CALIFORNIA BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | PASADENA |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 91105-3010 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 626-397-8335 |
| Practice Address - Fax: | 626-397-8337 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-01-29 |
| Last Update Date: | 2022-12-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207PH0002X | Allopathic & Osteopathic Physicians | Emergency Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2081H0002X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Hospice and Palliative Medicine | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| W13194F | Medicare PIN | ||
| CA | W13194I | Medicare PIN | |
| CA | W13194J | Medicare PIN | |
| CA | W13194F | Medicare PIN | |
| CA | W13194P | Medicare PIN | |
| CA | 4620550001 | Medicare NSC | |
| CA | W13407E | Medicare PIN | |
| CA | W13407A | Medicare PIN |