Provider Demographics
NPI:1417014275
Name:COMMUNITY HOSPITAL OF LOS GATOS, INC.
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL OF LOS GATOS, INC.
Other - Org Name:COMMUNITY HOSPITAL OF LOS GATOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2267
Mailing Address - Street 1:FILE 57434
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-7434
Mailing Address - Country:US
Mailing Address - Phone:209-578-2513
Mailing Address - Fax:408-866-4003
Practice Address - Street 1:815 POLLARD RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1438
Practice Address - Country:US
Practice Address - Phone:408-378-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOSPITAL OF LOS GATOS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000025273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
05-T188Medicare PIN