Healthcare Provider Details

I. General information

NPI: 1770636334
Provider Name (Legal Business Name): TORRANCE MEM MED CTR INP PHY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

IV. Provider business mailing address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-9110
  • Fax:
Mailing address:
  • Phone: 310-325-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberHSP15948
License Number StateCA

VIII. Authorized Official

Name: MR. STEVEN THOMPSON
Title or Position: PHARMACY DIRECTOR
Credential: PHARM.D
Phone: 310-325-9110