Provider Demographics
NPI:1841240157
Name:ARDENT HEALTHCARE, INC.
Entity type:Organization
Organization Name:ARDENT HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WYNNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-7410
Mailing Address - Street 1:PO BOX 80089
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8089
Mailing Address - Country:US
Mailing Address - Phone:213-484-7410
Mailing Address - Fax:
Practice Address - Street 1:2131 W 3RD ST
Practice Address - Street 2:ST VINCENT MEDICAL CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1901
Practice Address - Country:US
Practice Address - Phone:213-484-7410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty