Provider Demographics
NPI:1871261065
Name:PIH HEALTH DOWNEY HOSPITAL
Entity Type:Organization
Organization Name:PIH HEALTH DOWNEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE (SUE)
Authorized Official - Middle Name:R
Authorized Official - Last Name:PONCE (AKA CARLSON)
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-698-0811
Mailing Address - Street 1:11500 BROOKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4917
Mailing Address - Country:US
Mailing Address - Phone:562-904-5000
Mailing Address - Fax:
Practice Address - Street 1:11500 BROOKSHIRE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4917
Practice Address - Country:US
Practice Address - Phone:562-904-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIH HEALTH DOWNEY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility