Organization
ST. FRANCIS MEDICAL CENTER- CCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRELL TIDWELL LCSW (EXECUTIVE DIRECTOR)
(310) 900-8490
Entity
Organization
Contact information
Practice address
4390 TWEEDY BLVD, SOUTH GATE, CA 90280-6237
(310) 603-6949
(323) 566-4984
Mailing address
4390 TWEEDY BLVD, SOUTH GATE, CA 90280-6237
(310) 603-6949
(323) 566-4984
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
CA
Other
Enumeration date
03/21/2007
Last updated
02/06/2008
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