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Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Active
Parent organization
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORINA
Other names
Providence Little Company of Mary Medical Center San Pedro OBHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORINA
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1386 W 7TH ST # A, SAN PEDRO, CA 90732-3517
(310) 241-4330
(310) 241-4342
Mailing address
PO BOX 541024, LOS ANGELES, CA 90054-1024
(310) 303-7496
(310) 303-7575
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
282N00000X
General Acute Care Hospital
Primary
930000142
CA
Other
Enumeration date
07/02/2018
Last updated
05/09/2025
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