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Contact Information

PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA
4101 TORRANCE BLVD
TORRANCE, CA90503-4607
 Phone: 310-303-5777
 Fax: 310-303-5778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
 

Mail Order Pharmacy

3336M0002X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA

NPI # 1821010315
LBN Legal business name PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/24/2006
Last updated 05/09/2025 - More than a year ago
Identifiers
CA License # HSP47224
Other 1997017 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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