PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA (NPI# 1689875601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689875601 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA |
| Other Organization Name | PROVIDENCE HOLY CROSS TRAUMA CENTER |
| Practice Address |
15031 Rinaldi Street Mission Hills CA 91345-1207 |
| Practice Telephone | 8183658051 |
| Practice Fax Number | 8188984569 |
| Mailing Telephone | 8183658051 |
| Mailing Fax Number | 8188984569 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2014-03-24 |
| Authorized Official Name | MR. DAVID C MAST (CFO) |
| Authorized Official Telephone | 8188473388 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | CA | Allopathic & Osteopathic Physicians | |
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0101520 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Holy Cross Trauma Center | Doing Business As Name - Organization |
| Street Address |
15031 RINALDI STREET |
| City | MISSION HILLS |
| State | CA |
| Zip Code | 91345-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134273980 | Martin Eli Applebaum | Radiology | 15031 Rinaldi Street, Mission Hills, CA 91346-9600 | 2007-01-22 |
| 1154610897 | Peyman Mesbah Oskui | Internal Medicine | 15031 Rinaldi Street, Ace Medical Associates, Mission Hills, CA 91345 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141499 | Alpha Hospice | Hospice Care, Community Based | 15455 Devonshire St Suite 100a, Mission Hills, CA 91345 | 2020-10-12 |
| 1740725639 | Vivian Insua-lopez, Psy.d, Psychologist, Inc | Psychologist | 15455 San Fernando Misson Blvd., #308, Mission Hills, CA 91345 | 2016-12-30 |
| 1699162941 | Nancy M Kim Inc | Family Medicine | 11550 Indiana Hills Rd, 301, Mission Hills, CA 91345 | 2015-04-23 |
| 1881940088 | Prohealth-valley Occupational Medical Group | Clinic/Center | 10630 Sepulveda Blvd., Suite 100, Mission Hills, CA 91345 | 2012-07-25 |
| 1942588868 | Trauma & Critical Care Sfv Group Inc | Surgery | 11550 Indian Hills Road, Suite 310, Mission Hills, CA 91345 | 2011-07-26 |
| 1679860084 | Mirna G Villatoro | Residential Treatment Facility, Physical Disabilities | 11100 Sepulveda Blvd, # 232, Mission Hills, CA 91345 | 2011-07-06 |
| 1093010944 | Ana Yvette Alvarez | Rehabilitation Practitioner | 11565 Laurel Canyon Blvd. Suite 116, Mission Hills, CA 91345 | 2011-01-24 |
| 1811226392 | Tender Home Health | Home Health | 10117 Sepulveda Blvd Ste 205a, Mission Hills, CA 91345 | 2009-12-14 |
| 1033387279 | Jamal Elias Khoury | Chiropractor | 15336 Devonshire St. Ste 3, Mission Hills, CA 91345 | 2008-02-11 |
| 1043497282 | Ana Elena Aldana | Counselor | 10200 Sepulveda Blvd., Unit 100, Mission Hills, CA 91345 | 2008-01-30 |
| Find all providers in zip 91345 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942861182 | Justin Jacob Ramirez | Emergency Medicine | 11333 Sepulveda Blvd, Mission Hills, CA 91345-1116 | 2019-06-27 |
| 1639425663 | Ace Medical Associates, Inc. | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2012-07-27 |
| 1376556183 | Jay J Brown | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1407869225 | Bruce W. Cummings | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1407869233 | Charles Deng | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1518970151 | Michael D Sarti | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1497768030 | Thomas J Waskiewicz | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1114930757 | Scott A Wang | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-08-14 |
| 1780625871 | Cep America - California | Emergency Medicine | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134108 | Robert Rene Gosselin | Emergency Medicine | 14017 Banner Mtn Lookout Rd, Nevada City, CA 95959-9657 | 2020-11-06 |
| 1942811260 | Peter Mann Md Inc | Emergency Medicine | 7634 Girard Ave, La Jolla, CA 92037-4420 | 2020-08-11 |
| 1356959266 | Rgx Medical | Emergency Medicine | 1050 E Cypress Ave, Burbank, CA 91501-1310 | 2020-07-16 |
| 1942825112 | Blasko Medical Consultants Inc. | Emergency Medicine | 11576 Petunia Ct, Mira Loma, CA 91752-5013 | 2020-06-12 |
| 1316561517 | Sagen Consulting, PC | Emergency Medicine | 10053 Bret Ave, Cupertino, CA 95014-3518 | 2020-06-03 |
| 1265051304 | Madhok Medical Corporation | Emergency Medicine | 2309 Noriega St # 5, San Francisco, CA 94122-4239 | 2020-04-09 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1376177402 | Aria Urgent Care Associates, Inc | Emergency Medicine | 601 S Beach Blvd, Anaheim, CA 92804-3102 | 2020-02-27 |
| 1851922900 | Anna Lankester Webster | Emergency Medicine | 1600 Los Gamos Dr Ste 220, San Rafael, CA 94903-1842 | 2020-01-28 |
| 1487294385 | Cep America - Auc PC | Emergency Medicine | 240 La Casa Via Ste 200, Walnut Creek, CA 94598-4866 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
| City | MISSION HILLS |
| Zip Code | 91345 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.