Healthcare Provider Details

I. General information

NPI: 1063412005
Provider Name (Legal Business Name): GARDENA HOSPITAL LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 W REDONDO BEACH BLVD
GARDENA CA
90247-3528
US

IV. Provider business mailing address

222 N SEPULVEDA BLVD SUITE 950
EL SEGUNDO CA
90245-5648
US

V. Phone/Fax

Practice location:
  • Phone: 310-512-6169
  • Fax:
Mailing address:
  • Phone: 310-356-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number930000098
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000098
License Number StateCA

VIII. Authorized Official

Name: MR. JAMES P MACPHERSON
Title or Position: OWNER
Credential:
Phone: 310-356-0550