Healthcare Provider Details
I. General information
NPI: 1750245783
Provider Name (Legal Business Name): SAN PEDRO HOSPITALIST MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 W 7TH ST STE 600
SAN PEDRO CA
90732-3505
US
IV. Provider business mailing address
898 N PACIFIC COAST HWY STE 600
EL SEGUNDO CA
90245-2747
US
V. Phone/Fax
- Phone: 310-832-3311
- Fax:
- Phone: 310-321-0413
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
BELL
Title or Position: PRESIDENT
Credential: MD
Phone: 424-241-1546