Provider Demographics
NPI:1790847002
Name:PACIFICA OF THE VALLEY CORPORATION
Entity Type:Organization
Organization Name:PACIFICA OF THE VALLEY CORPORATION
Other - Org Name:PACIFICA HOSPITAL OF THE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ONEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-252-2488
Mailing Address - Street 1:9449 SAN FERNANDO ROAD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352
Mailing Address - Country:US
Mailing Address - Phone:818-767-3310
Mailing Address - Fax:818-252-2497
Practice Address - Street 1:9449 SAN FERNANDO ROAD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352
Practice Address - Country:US
Practice Address - Phone:818-767-3310
Practice Address - Fax:818-252-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
050378Medicare ID - Type Unspecified