Provider Demographics
NPI:1417089426
Name:PRIME HEALTHCARE ANAHEIM REGIONAL LLC
Entity Type:Organization
Organization Name:PRIME HEALTHCARE ANAHEIM REGIONAL LLC
Other - Org Name:ANAHEIM REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT & GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SARRAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-464-8847
Mailing Address - Street 1:12479 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2670
Mailing Address - Country:US
Mailing Address - Phone:909-464-8847
Mailing Address - Fax:909-464-8887
Practice Address - Street 1:1111 W LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2804
Practice Address - Country:US
Practice Address - Phone:909-464-8847
Practice Address - Fax:909-464-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital