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Organization

VISTA HOSPITAL OF SOUTH BAY, LP

Active
Parent organization
VISTA HEALTHCARE, LLC
Other names
Vista Hospital of South Bay - Tri-City Campus
Organization subpart
Yes

Provider details

NPI number
Legal business name
VISTA HEALTHCARE, LLC
Authorized official
MR. MARC C. FERRELL (SENIOR VICE-PRESIDENT)
(909) 581-7272
Entity
Organization

Contact information

Practice address
21530 PIONEER BLVD, HAWAIIAN GARDENS, CA 90716-2608
(562) 860-4488
(562) 860-4489
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
930000037
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HSP30456I
CA
05
HSP40456I
CA
Enumeration date
05/27/2010
Last updated
05/27/2010
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