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General NPI Number Information
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NPI Number | 1568532133
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Entity Type | Organization
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Legal Business Name | GARDENA PHYSICIANS HOSPITAL, INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 1246 W 155TH ST
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City | GARDENA
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State | CA
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Zip | 90247-4011
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Country | US
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Telephone | 310-768-2235
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Fax | 310-768-2265
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Provider Business Mailing Address
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Address Line | 1300 W 155TH ST STE 102
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City | GARDENA
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State | CA
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Zip | 90247-4049
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Country | US
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Telephone | 714-488-3188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND SMITH
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Credential |
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Telephone | 714-488-3188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | CA
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