1518349216 NPI number — ST JUDE HOSPITAL YORBA LINDA, INC.

Table of content: DR. ANDREW WAYNE SWARTZ M.D. (NPI 1336158401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518349216 NPI number — ST JUDE HOSPITAL YORBA LINDA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST JUDE HOSPITAL YORBA LINDA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518349216
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 31001-1920
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91110-1920
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3355 MICHELSON DR
Provider Second Line Business Practice Location Address:
STE. 490
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92612-0684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-526-8375
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MYCROFT
Authorized Official First Name:
TINA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
714-937-7023

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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