NPIMap

Organization Active NPI

St. Jude Hospital, Inc. Dba St. Jude Medical Center

  • General Acute Care Hospital
  • Brea, CA
National Provider Identifier
1558428235
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
060000173 Issued in CA
Legal business name
ST. JUDE HOSPITAL, INC. DBA ST. JUDE MEDICAL CENTER
Practice address
2767 E Imperial Hwy
Second Floor
Brea, CA 92821-6713
Phone
(714) 870-3540
Fax
(714) 870-3525
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Authorized official

Name
Mrs. Maggie Ilagan
Title
Manager, Patient Financial Services
Phone
(714) 870-3510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 060000173 CA Primary

Addresses

Primary practice location

2767 E Imperial Hwy
Second Floor
Brea, CA 92821-6713

Mailing address

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 992-3000

Other identifiers 3

IdentifierTypeStateIssuer
ZZT30168FMedicaidCA
HSC30168FMedicaidCA
ZZT40168FMedicaidCA

National Provider Directory

National Provider Directory

Locations

2151 N Harbor Blvd
Ste 2100
Fullerton, CA 92835
Phone (714) 446-7181

2141 N Harbor Blvd
Ste 16000
Fullerton, CA 92835
Phone (714) 446-5600

Dept LA 21028
Pasadena, CA 91185

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1558428235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353809",
            "telephone_number": "714-992-3000",
            "fax_number": "714-870-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 E IMPERIAL HWY",
            "address_2": "SECOND FLOOR",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216713",
            "telephone_number": "714-870-3540",
            "fax_number": "714-870-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE HOSPITAL, INC. DBA ST. JUDE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "ILAGAN",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "MANAGER, PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "714-870-3510",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "060000173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30168F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30168F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40168F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.