Provider Demographics
NPI:1740487859
Name:SIMI VALLEY HOSPITAL & HEALTH CARE SERVICES
Entity type:Organization
Organization Name:SIMI VALLEY HOSPITAL & HEALTH CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-955-6202
Mailing Address - Street 1:2975 N. SYCAMORE DR.
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:96065-1201
Mailing Address - Country:US
Mailing Address - Phone:805-955-6000
Mailing Address - Fax:805-526-0837
Practice Address - Street 1:2975 N. SYCAMORE DR.
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1201
Practice Address - Country:US
Practice Address - Phone:805-955-6000
Practice Address - Fax:805-526-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000216282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHB327710Medicaid
CAPHB327710Medicaid