PROVIDENCE MEDICAL INSTITUTE NPI 1235182569

NPI Information

NPI: 1235182569
Provider Name: PROVIDENCE MEDICAL INSTITUTE

Doing Business As: PROVIDENCE LITTLE COMPANY OF MARY MEDICAL INSTITUTE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

Address:
4101 TORRANCE BLVD
TORRANCE, CA
ZIP 90503
Phone: (310) 793-8075
Get Directions

PROVIDENCE MEDICAL INSTITUTE is a family medicine in Torrance, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE MEDICAL INSTITUTE NPI is 1235182569. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Little Company Of Mary Medical Institute.

The provider's business location address is:

4101 TORRANCE BLVD
TORRANCE, CA
ZIP 90503-607
Phone: (310) 793-8075
Fax: (310) 793-8195

The provider's authorized official is Kelly Kurcz .
The authorized official title is Chief Operating Officer and has the following contact phone number (310) 793-8075.

The CLIA number assigned to this NPI record is 05D0687721 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 2/9/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207R00000X	Internal Medicine		No
2	208000000X	Pediatrics		No
3	207V00000X	Obstetrics & Gynecology		No
4	208M00000X	Hospitalist		No
5	207P00000X	Emergency Medicine		No
6	207N00000X	Dermatology		No
7	207RR0500X	Internal Medicine	Rheumatology	No
8	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
9	207X00000X	Orthopaedic Surgery		No
10	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W13660A	MEDICARE ID-TYPE UNSPECIFIED		MEDICARE GROUP PPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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