Provider Demographics
NPI:1083664841
Name:PIH HEALTH WHITTIER HOSPITAL
Entity Type:Organization
Organization Name:PIH HEALTH WHITTIER HOSPITAL
Other - Org Name:PRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPECIAL PROJECTS
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PONCE (AKA CARLSON)
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-698-0811
Mailing Address - Street 1:PO BOX 1277
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90609-1277
Mailing Address - Country:US
Mailing Address - Phone:562-789-5401
Mailing Address - Fax:562-789-5912
Practice Address - Street 1:12291 WASHINGTON BLVD
Practice Address - Street 2:500
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2500
Practice Address - Country:US
Practice Address - Phone:562-698-2541
Practice Address - Fax:562-698-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52601207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN