Basic Information
| Provider Information | |||||||||
| NPI: | 1467459776 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TORRANCE MEMORIAL MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3330 LOMITA BLVD | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905055002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103259110 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3330 LOMITA BLVD | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905055002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103259110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| AuthorizedOfficialLastName: | LARSON | ||||||||
| AuthorizedOfficialFirstName: | BILL | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 3103259110 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 930000076 | CA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | CGP019615 | 01 | CA | CALIFORNIA CHILDREN SERV | OTHER | ZZT40351F | 05 | CA | MEDICAID | HSC30351F | 05 | CA | MEDICAID | 197696900 | 01 | CA | DEPARTMENT OF LABOR | OTHER | ZZT30351F | 05 | CA | MEDICAID | ZZZA1958Z | 01 | CA | BLUE SHIELD | OTHER | LTC55599F | 05 | CA | MEDICAID |