Providence St. Mary Medical Center

LBN: St. Mary Medical Center
Providence St. Mary Medical Center is an health care organization with primary practice located at 18077 Us Highway 18 , Apple Valley CA 92307-2150. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as the primary health care specialty. St. Mary Medical Center can be contacted via phone (760) 946-8169, or through Castillo, Randall via phone (760) 946-8195.

Contact Information

Primary practice address
18077 Us Highway 18 Apple Valley CA 92307-2150
Phone: (760) 946-8169
Fax: (760) 946-8875
Website:
Map and Directions
Authorized official contact:
Name: Castillo, Randall
Phone: (760) 946-8195

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X NMW1225 California

Profile Details

NPI number 1043406440
LBN Legal business name St. Mary Medical Center
DBA Doing business as Providence St. Mary Medical Center
Authorized official Castillo, Randall
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2007
Last updated Dec 16th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043406440 NPPES
California Other GNMW00060 MEDICAL

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