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LITTLE COMPANY OF MARY - SAN PEDRO NPI 1316989791


NPI Information

NPI: 1316989791
Provider Name: LITTLE COMPANY OF MARY - SAN PEDRO

Doing Business As: LITTLE COMPANY OF MARY PAVILION SAN - PEDRO

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 05D0915830

Address:
1300 W 7TH ST
SAN PEDRO, CA
ZIP 90732
Phone: (310) 303-7496
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LITTLE COMPANY OF MARY - SAN PEDRO is a skilled nursing facility in San Pedro, CA. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. LITTLE COMPANY OF MARY - SAN PEDRO NPI is 1316989791. The provider is registered as an organization entity type.
The provider Is Doing Business As Little Company Of Mary Pavilion San - Pedro.

The provider's business location address is:

1300 W 7TH ST
SAN PEDRO, CA
ZIP 90732-505
Phone: (310) 303-7496
Fax: (310) 303-7575

The provider's authorized official is Elizabeth Zuanich .
The authorized official title is Cfo and has the following contact phone number (310) 303-7496.

The CLIA number assigned to this NPI record is 05D0915830 - ancillary test site with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 4/27/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing FacilityYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZM1977BOTHERCALIFORNIABLUE SHIELD
2056297OTHERCALIFORNIABLUE CROSS
3ZZT06297HMEDICAIDCALIFORNIA
4LTX06297HMEDICAIDCALIFORNIA
5056297MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE PROVIDER NUMBER

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: 11/14/2023

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