Provider Demographics
NPI:1194543124
Name:ST.ANTHONY MEDICAL CENTERS
Entity type:Organization
Organization Name:ST.ANTHONY MEDICAL CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-388-1543
Mailing Address - Street 1:13865 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7011
Mailing Address - Country:US
Mailing Address - Phone:310-331-0555
Mailing Address - Fax:310-759-0555
Practice Address - Street 1:13865 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7011
Practice Address - Country:US
Practice Address - Phone:310-331-0555
Practice Address - Fax:310-759-0555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST.ANTHONY MEDICAL CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)