| NPI | 1053567305 |
|---|---|
| Doing Business As | ST JUDE HERITAGE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JOHN C BENNETT Vice President 714-578-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207N00000X Dermatology | |
| 207Q00000X Family Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 208200000X Plastic Surgery | |
| 208600000X Surgery | |
| 208C00000X Colon & Rectal Surgery | |
| 208D00000X General Practice | |
| 208M00000X Hospitalist | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |