Provider Demographics
NPI:1104032564
Name:ANAHIEM MEMORIAL MEDICAL CENTER
Entity Type:Organization
Organization Name:ANAHIEM MEMORIAL MEDICAL CENTER
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:ONO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-999-3933
Mailing Address - Street 1:1111 W LA PALMA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2804
Mailing Address - Country:US
Mailing Address - Phone:714-999-3800
Mailing Address - Fax:714-999-6087
Practice Address - Street 1:1111 W LA PALMA AVE
Practice Address - Street 2:1111 W LA PALMA AVENUE
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2804
Practice Address - Country:US
Practice Address - Phone:714-999-3800
Practice Address - Fax:714-999-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHSP45448282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital