Provider Demographics
NPI:1225010994
Name:SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES
Other - Org Name:ADVENTIST HEALTH/HOME CARE SERVICES
Other - Org Type:Doing Business As
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 N. SYCAMORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-955-6000
Mailing Address - Fax:805-526-0837
Practice Address - Street 1:1850 HEYWOOD ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3430
Practice Address - Country:US
Practice Address - Phone:805-526-8190
Practice Address - Fax:805-526-4690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM/WEST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-17
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000004251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-7537Medicare ID - Type UnspecifiedPROVIDER NUMBER