Organization · Type 2 NPI

St. Jude Hospital, Inc.

Primary Care Clinic/Center · Fullerton, CA

NPI number 1386869907 Active

Practice location

731 South Highland Avenue
Fullerton, CA 92832

Specialties and licenses

Taxonomy	Code	License
Primary Care Clinic/Center Primary	261QP2300X	70906F (CA)

Primary Care Clinic/Center: Definition to come...

2 other providers at this address

St. Jude Hospital, Inc.Primary Care Clinic/Center Fullerton, CA NPI 1336262344
St. Jude Hospital, Inc.Primary Care Clinic/Center Fullerton, CA NPI 1932324555

Other primary care clinic/center providers in Fullerton

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NPI record

NPI: 1386869907
Entity type: Organization (Type 2)
Issued: Apr 17, 2007
Last updated: Feb 27, 2008
Status: Active
Subpart: Yes of St. Jude Hospital, Inc.

Other names

<unavail>
St. Jude Mobile Health Clinic 1 · doing business as

Authorized official

Mr. Barry Ross, RN
Vice President, Healthy Communities
(714) 992-3164

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386869907

St. Jude Hospital, Inc.'s National Provider Identifier is 1386869907, issued on Apr 17, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Fullerton, CA. The record was last updated on Feb 27, 2008.