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Organization
SAN PEDRO PENINSULA HOSPITAL
Active
Organization
SAN PEDRO PENINSULA HOSPITAL
Active
Other names
San Pedro Peninsula Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH ZUANICH (CFO)
(310) 303-7496
Entity
Organization
Contact information
Practice address
1322 W 6TH ST, SAN PEDRO, CA 90732-3501
(310) 303-7496
(310) 303-7575
Mailing address
PO BOX 6668, SAN PEDRO, CA 90734-6668
(310) 303-7496
(310) 303-7575
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056297
BLUE CROSS PROV#
CA
05
—
LTX06297G
—
CA
05
—
ZZT06297G
—
CA
01
—
ZZZM1977B
BLUE SHIELD PROV#
CA
Enumeration date
07/27/2006
Last updated
04/27/2009
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