NPIMap

Organization Active NPI

Pih Health Whittier Hospital

  • Prosthetic/Orthotic Supplier
  • Whittier, CA
National Provider Identifier
1043205180
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
930000129 Issued in CA
Legal business name
PIH HEALTH WHITTIER HOSPITAL
Practice address
12393 Washington Blvd
Whittier, CA 90606-2502
Phone
(562) 698-0811
Fax
(562) 698-6238
NPI assigned
Sep 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sue R Ponce (Aka Carlson)
Title
Special Projects
Phone
(562) 698-0811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 930000129 CA Primary

Addresses

Primary practice location

12393 Washington Blvd
Whittier, CA 90606-2502

Mailing address

12401 Washington Blvd
Whittier, CA 90602-1006
Phone (562) 698-0811

Other names 3

  • MARIPOSA BOUTIQUE Doing business as
  • PIH Health Hospital Whittier Former legal business name
  • PIH HEALTH HOSPITAL-WHITTIER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930008010 CA DME Supplier - Medical Supply Company 3678545308 Practice locations: Whittier, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mariposa Boutique12393 Washington Blvd, Whittier, CA 90606-2502(562) 698-0811 Breast Prostheses and/or Accessories Accepts assignmentParticipating since Jan 1, 1989

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Intercom H9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pih Health Whittier Hospital Transitional Care UnitWhittier, CA, CCN 555654 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 15, 1996
Nov 8, 2024
Dec 13, 2024
Pih Health Good Samaritan HospitalLos Angeles, CA, CCN 555927 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Feb 19, 2025
Pih Health Home Healthcare - HospiceLa Mirada, CA, CCN 051542 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2013

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1043205180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811",
            "fax_number": "562-698-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12393 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062502",
            "telephone_number": "562-698-0811",
            "fax_number": "562-698-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIH HEALTH WHITTIER HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "PONCE (AKA CARLSON)",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPECIAL PROJECTS",
        "authorized_official_telephone_number": "562-698-0811"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "930000129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARIPOSA BOUTIQUE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIH Health Hospital Whittier",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PIH HEALTH HOSPITAL-WHITTIER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.