Organization
VISTA HOSPITAL OF SOUTH BAY, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC C FERRELL (SENIOR VP)
(562) 715-0974
Entity
Organization
Contact information
Practice address
1246 W 155TH ST, GARDENA, CA 90247-4011
(310) 323-5330
(310) 768-2265
Mailing address
1246 W 155TH ST, GARDENA, CA 90247-4011
(310) 323-5330
(310) 768-2265
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSP30456I
—
CA
05
—
HSP40456I
—
CA
Enumeration date
10/03/2006
Last updated
10/24/2007
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