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NPI Code Detail

MEDICARE: ST VINCENT MEDICAL CENTER

MEDICARE: ST VINCENT MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care HospitalHSP 45704CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15644287OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1124004304
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST VINCENT MEDICAL CENTER
Provider Business Mailing Address
First Line : 2131 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-1901
Country : US
Telephone Number : 213-484-7402
Fax Number :
Provider Business Practice Location Address
First Line : 2131 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-1901
Country : US
Telephone Number : 213-484-7402
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : NORMAN WILLIS
Credential :
Telephone Number : 213-484-7111
Provider Enumeration Date : 12/19/2005
Last Update Date : 10/18/2013

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Directions to “ST VINCENT MEDICAL CENTER ” Practice Location

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