Providence Health System - Southern California
NPI #1770639809 in San Pedro, California
Provider Information
- NPI Number
- 1770639809
- Entity Type
- Organization
- Organization Name
- Providence Health System - Southern California
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jan 25, 2007
- Last Updated
- May 9, 2025
Practice Location
- Address
- 1322 W 6TH ST
- City
- San Pedro
- State
- California
- ZIP Code
- 90732-3501
- Phone
- (310) 303-7496
Authorized Official
- Name
- DONALD W ANDERSON JR.
- Title
- ASSISTANT SECRETARY ENROLLMENTS
- Phone
- (425) 358-9786
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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