East Valley Glendora Hospital LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

EAST VALLEY GLENDORA HOSPITAL LLC

Practice address

150 W Route 66
Glendora, CA 91740-6207

Phone

(626) 852-6125

Fax

(626) 852-5055

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Christopher A. Doan

Title

Managing Associate General Counsel

Phone

(103) 259-4706

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Glendora Oaks Behavioral Health Hospital Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Health Emergency Assistance of Detroit

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1285092767

  Member Of

  NPD member

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1649307489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E GUASTI RD FL 3",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618655",
            "telephone_number": "909-235-4400",
            "fax_number": "909-235-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406207",
            "telephone_number": "626-852-6125",
            "fax_number": "626-852-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY GLENDORA HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "103-259-4706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30205I",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30205I",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40205I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendora Oaks Behavioral Health Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda E Duncan, PA-C
• Mariela Duran-Troncoso, LMFT
• Alyviah Durham, PA-C
• Jenna D Duvall, OTR/L
• East Valley Emergency Medical Associates, Inc.
• East Valley Glendora Hospital LLC
• East Valley Hospital Medical Center
• East Valley Pathology Medical Group
• Mary Ann Ebba, DMD
• Anna Lynn Edwards, N.P.

• Psychiatric Hospital in Glendora, CA
• Providers in Glendora, CA by specialty
• Psychiatric Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.