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General NPI Number Information
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NPI Number | 1164628863
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Entity Type | Organization
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Legal Business Name | ST. VINCENT MEDICAL CENTER
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 2200 W 3RD ST SUITE #500
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City | LOS ANGELES
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State | CA
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Zip | 90057-1932
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Country | US
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Telephone | 213-484-7064
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 W 3RD ST SUITE #500
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City | LOS ANGELES
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State | CA
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Zip | 90057-1932
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Country | US
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Telephone | 213-484-7064
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | MRS. MI MI CHANG
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Credential |
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Telephone | 213-484-7064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 370333
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License Number State | CA
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