Provider Demographics
NPI:1114059557
Name:HENRY MAYO NEWHALL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HENRY MAYO NEWHALL MEMORIAL HOSPITAL
Other - Org Name:HENRY MAYO NEWHALL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-253-8000
Mailing Address - Street 1:23845 MCBEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2001
Mailing Address - Country:US
Mailing Address - Phone:661-200-1021
Mailing Address - Fax:661-200-1042
Practice Address - Street 1:23845 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-253-8000
Practice Address - Fax:661-200-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05T624Medicare Oscar/Certification