# PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Little Company of Mary Medical Center San Pedro, Prov Little Co of Mary San Pedro
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942247291
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 1300 W 7TH ST, SAN PEDRO, CA 90732-3505
- **Practice address phone:** (310) 303-7496
- **Practice address fax:** (310) 303-7575
- **Mailing address:** PO BOX 2335, SPOKANE, WA 99210-2335
- **Mailing address phone:** (310) 303-7496
- **Mailing address fax:** (310) 303-7575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | CA | Yes |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 05/09/2025