Organization
SAN PEDRO PENINSULA HOSPITAL
Active
Other names
San Pedro Peninsula Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH ZUANICH (CFO)
(310) 303-7496
Entity
Organization
Contact information
Practice address
1322 W 6TH ST, SAN PEDRO, CA 90732-3501
(310) 303-7496
(310) 303-7575
Mailing address
PO BOX 6668, SAN PEDRO, CA 90734-6668
(310) 303-7496
(310) 303-7575
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056297
BLUE CROSS PROV#
CA
05
—
LTX06297G
—
CA
05
—
ZZT06297G
—
CA
01
—
ZZZM1977B
BLUE SHIELD PROV#
CA
Enumeration date
07/27/2006
Last updated
04/27/2009
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