Provider Demographics
NPI:1063495190
Name:SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-955-6202
Mailing Address - Street 1:2975 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1201
Mailing Address - Country:US
Mailing Address - Phone:805-955-6000
Mailing Address - Fax:805-526-0837
Practice Address - Street 1:2975 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1201
Practice Address - Country:US
Practice Address - Phone:805-955-6000
Practice Address - Fax:805-526-0837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM/WEST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-22
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000216282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050236Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER