PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA (NPI# 1508972456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508972456 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA |
| Other Organization Name | PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO |
| Practice Address |
1300 W 7th St San Pedro CA 90732-3505 |
| Practice Telephone | 3108323311 |
| Practice Fax Number | 3105145462 |
| Mailing Telephone | 3105145267 |
| Mailing Fax Number | 3105145462 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2012-03-02 |
| Authorized Official Name | HIRO NISHI (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 3105145268 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
HSP47226 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHB472260 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 0544519 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Little Company of Mary Medical Center San Pedro | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700890514 | Providence Health System-southern California | Home Health | 5315 Torrance Blvd, Ste B-169, Torrance, CA 90503-4011 | 2006-07-28 |
| 1164429684 | Providence Health System-southern California | Home Health | 3413 W Pacific Ave, Ste 201, Burbank, CA 91505-1555 | 2005-06-30 |
| 1356962385 | Providence Health System-southern California | Pharmacy | 18370 Burbank Blvd Ste 104, Tarzana, CA 91356-2804 | 2020-04-30 |
| 1821250762 | Providence Health System-southern California | General Acute Care Hospital | 18321 Clark St, Tarzana, CA 91356-3501 | 2008-07-01 |
| 1821010315 | Providence Health System-southern California | Pharmacy | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-07-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA | 501 S Buena Vista St, Burbank, CA 91505-4809 |
| Street Address |
1300 W 7TH ST |
| City | SAN PEDRO |
| State | CA |
| Zip Code | 90732-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356323828 | Jason C Kantor | Radiology | 1300 W 7th St, San Pedro, CA 90732-3505 | 2005-11-18 |
| 1598366486 | Nina Sabet-peyman, Md Inc. | Hospice, Inpatient | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-11-05 |
| 1154922185 | Melissa Louise Zankich-patalan | Nurse Practitioner | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-11-05 |
| 1063011104 | Christina Margarita Villasenor | Occupational Therapist | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-10-20 |
| 1073125480 | Peguy-emmanuelle Alva | Registered Nurse | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-08-18 |
| 1518588433 | Southern California Emergency Medical Group | Emergency Medicine | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-05-01 |
| 1033748744 | Jenna Nicole East | Speech-Language Pathologist | 1300 W 7th St, San Pedro, CA 90732-3505 | 2020-04-04 |
| 1023654555 | Susan Marie Smith | Registered Nurse | 1300 W 7th St, San Pedro, CA 90732-3505 | 2019-11-19 |
| 1477196269 | Vilma Asuma | Registered Nurse | 1300 W 7th St, San Pedro, CA 90732-3505 | 2019-10-24 |
| 1932742905 | Professional Anesthesia Associates PC | Nurse Anesthetist, Certified Registered | 1300 W 7th St, San Pedro, CA 90732-3505 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771241 | Alicia Avila | Student in an Organized Health Care Education/Training Program | 2227 Blue Butterfly Way, #7, San Pedro, CA 90732 | 2020-08-24 |
| 1619500543 | Udana Harris | Registered Nurse | 1300 West 7th Street, Obhc Unit, San Pedro, CA 90732 | 2020-02-19 |
| 1861042301 | Patricia Elaine Moses | Technician | 106 N. Western Ave Unit 102, San Pedro, CA 90732 | 2019-09-17 |
| 1629627393 | Antonio Ramon Martinez | Technician | 3141 Blue Butterfly Unit 66, San Pedro, CA 90732 | 2019-09-05 |
| 1487207700 | Victoria A. Shook, D.d.s., A Professional Corp. | Dentist | 28138 S. Western Ave., San Pedro, CA 90732 | 2019-07-17 |
| 1144566563 | Shaun E Chandran M D Inc | Orthopaedic Surgery | 1360 W 6th Street, Suite 305, San Pedro, CA 90732 | 2012-12-13 |
| 1316281280 | Jenny Luong | Physician Assistant | 1534 W. 25th St, San Pedro, CA 90732 | 2012-11-16 |
| 1033429519 | Eric M Feit Dpm Inc | Podiatrist | 1360 West 6th St., Suite 240, San Pedro, CA 90732 | 2010-10-18 |
| 1386808673 | Meysam Zaker | Dentist | 2470 S. Western Ave, San Pedro, Ca, CA 90732 | 2008-07-15 |
| 1376735340 | Francisco J. Correa, M.d., Inc | General Practice | 1350 W. 6th St, #3, San Pedro, CA 90732 | 2007-08-14 |
| Find all providers in zip 90732 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457906745 | Corrections and Rehabilitation | Pharmacy | 5th and Western Ave, Module M, Room #104, Norco, CA 92860 | 2019-08-05 |
| 1982169694 | Vikki Lam | Pharmacy | 757 Westwood Plz # B-504j, Los Angeles, CA 90095-8358 | 2019-02-06 |
| 1760827414 | Cedars-sinai Medical Center | Pharmacy | 127 S San Vicente Blvd Ste 2403, Los Angeles, CA 90048-3311 | 2013-05-08 |
| 1508105354 | Sutter Central Valley Hospitals | Pharmacy | 1420 N. Tracy Blvd., Tracy, CA 95376 | 2013-02-13 |
| 1649576364 | Wade J Dahlberg Sr | Pharmacy | 2697 Lavery Ct Ste 7, Newbury Park, CA 91320-1587 | 2011-01-27 |
| 1871898304 | Corrections and Rehabilitation | Pharmacy | 5100 O'byrnes Ferry Road, Attn: Pharmacy, Jamestown, CA 95327 | 2011-01-13 |
| 1437469202 | Institutional Pharmacy Solutions LLC | Pharmacy | 6520 N Irwindale Ave Ste 228, Irwindale, CA 91702-2867 | 2010-10-14 |
| 1851593560 | Belville Enterprises Inc | Pharmacy | 10140 Barnes Canyon Rd, San Diego, CA 92121-2724 | 2007-06-04 |
| 1306057229 | Detention's Facility Pharmacy | Pharmacy | 8525 Gibbs Dr Ste 101, San Diego, CA 92123-1758 | 2007-05-24 |
| 1407992019 | San Joaquin County | Pharmacy | 7000 Michael Canlis Way, French Camp, CA 95231-9781 | 2007-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.