Provider Demographics
NPI:1710545249
Name:RIDGECREST REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:RIDGECREST REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-499-3995
Mailing Address - Street 1:1081 N CHINA LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3130
Mailing Address - Country:US
Mailing Address - Phone:760-446-3551
Mailing Address - Fax:
Practice Address - Street 1:840 N NORMA ST STE B
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3570
Practice Address - Country:US
Practice Address - Phone:760-371-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIDGECREST REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-30
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty