NPIMap

Organization Active NPI

Pih Health Whittier Hospital

Doing business as The Intercommunity Diagnostic Radiology Center an Affiliate of PIH

  • Radiology Clinic/Center
  • La Mirada, CA
National Provider Identifier
1790928984
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PIH HEALTH WHITTIER HOSPITAL
Doing business as
The Intercommunity Diagnostic Radiology Center an Affiliate of PIH
Practice address
12675 La Mirada Blvd
La Mirada, CA 90638-2200
Phone
(562) 698-0811
NPI assigned
Apr 17, 2009
Last updated
Jul 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 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
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

12675 La Mirada Blvd
La Mirada, CA 90638-2200

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
HSC30169FMedicaidCA
ZZT40169FMedicaidCA

Other names 2

  • The Intercommunity Diagnostic Radiology Center an Affiliate of PIH Doing business as
  • Presbyterian Intercommunity Hospital, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Intercom C9 organizations share this tax ID, including this one
Part of
Presbyterian Intercom C

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1790928984",
    "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": "12675 LA MIRADA BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382200",
            "telephone_number": "562-698-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIH HEALTH WHITTIER HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.",
        "enumeration_date": "2009-04-17",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "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": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30169F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40169F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Intercommunity Diagnostic Radiology Center an Affiliate of PIH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Intercommunity Diagnostic Radiology Center an Affiliate of PIH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Intercommunity Hospital, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.