Provider Demographics
NPI:1295421816
Name:HOSPITAL PABLO NERUDA
Entity type:Organization
Organization Name:HOSPITAL PABLO NERUDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:EZQUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:888-449-7799
Mailing Address - Street 1:13918 E MISSISSIPPI AVE # 61825
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3603
Mailing Address - Country:US
Mailing Address - Phone:888-449-7799
Mailing Address - Fax:
Practice Address - Street 1:PABLO NERUDA 4150
Practice Address - Street 2:
Practice Address - City:ZAPOPAN
Practice Address - State:JALISCO
Practice Address - Zip Code:45110
Practice Address - Country:MX
Practice Address - Phone:888-449-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital