Organization
PROVIDENCE LITTLE CO. OF MARY HOSPITAL IN SAN PEDRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARNULFO TARROBAGO FERNANDEZ JR. RN (PET TEAM)
(310) 514-5480
Entity
Organization
Contact information
Practice address
1300 W 7TH ST, SAN PEDRO, CA 90732-3505
(310) 514-5480
Mailing address
1018 8TH ST, HERMOSA BEACH, CA 90254-4311
(310) 936-6161
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
369004
—
CA
Enumeration date
02/02/2022
Last updated
02/02/2022
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