Provider Demographics
NPI:1922263797
Name:PRIME HEALTHCARE SERVICES - SHERMAN OAKS, LLC
Entity Type:Organization
Organization Name:PRIME HEALTHCARE SERVICES - SHERMAN OAKS, LLC
Other - Org Name:SHERMAN OAKS HOSPITAL - PSYCH UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING ASSOCIATE GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-259-4706
Mailing Address - Street 1:4929 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1702
Mailing Address - Country:US
Mailing Address - Phone:818-907-4540
Mailing Address - Fax:818-907-4527
Practice Address - Street 1:4929 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1702
Practice Address - Country:US
Practice Address - Phone:818-907-4540
Practice Address - Fax:818-907-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
05S755Medicare Oscar/Certification