Providence Health System - Southern California

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA

Practice address

15031 Rinaldi Street
Mission Hills, CA 91345-1207

Phone

(818) 365-8051

Fax

(818) 898-4569

NPI assigned

May 29, 2007

Organization subpart

Yes

Parent organization

PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Donald W Anderson Jr.

Title

Assistant Secretary Enrollments

Phone

(425) 358-9786

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Providence Holy Cross Trauma Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Part of

Providence Health System-Southern California

Practitioners 6

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

• Boris H Borazjani, M.D.,M.P.H.

  • Trauma Surgery Physician
  • Mission Hills, CA
  • NPI 1730356353
  Medicare reassignment NPD
• Stephen Alan Hillman, M.D.

  • Anesthesiology Physician
  • Burbank, CA
  • NPI 1831112036
  Medicare reassignment NPD
• Quynh Thien Quach, D.O.

  • Anesthesiology Physician
  • Burbank, CA
  • NPI 1023046422
  Medicare reassignment NPD
• Bradley J Roth, MD

  • Trauma Surgery Physician
  • Mission Hills, CA
  • NPI 1699709048
  Medicare reassignment NPD
• Haskim Babken Sarkissian, M.D.

  • Anesthesiology Physician
  • Burbank, CA
  • NPI 1699796888
  Medicare reassignment NPD
• Oleg Vosicher, M.D.

  • Anesthesiology Physician
  • Burbank, CA
  • NPI 1437256021
  Medicare reassignment NPD

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1689875601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15031 RINALDI STREET",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451207",
            "telephone_number": "818-365-8051",
            "fax_number": "818-898-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15031 RINALDI STREET",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451207",
            "telephone_number": "818-365-8051",
            "fax_number": "818-898-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA",
        "enumeration_date": "2007-05-29",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Holy Cross Trauma Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Holy Cross Trauma Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Professional Nurses Home Care Inc
• Prohealth Medical Group, Inc
• Prohealth-Valley Occupational Medical Group
• Providence Facey Medical Foundation
• Providence Health System - Southern California
• Providence Health System - Southern California
• Providence Health System - Southern California
• Providence Holy Cross Medical Center
• Providence Pediatrics Inc
• Brittany Lorraine Pulido

• Emergency Medicine Physician in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.