Provider Demographics
NPI:1407876766
Name:LITTLE COMPANY OF MARY HOSPITAL
Entity Type:Organization
Organization Name:LITTLE COMPANY OF MARY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUANICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-303-7561
Mailing Address - Street 1:PO BOX 541100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90054-1100
Mailing Address - Country:US
Mailing Address - Phone:310-303-7561
Mailing Address - Fax:310-303-7575
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4607
Practice Address - Country:US
Practice Address - Phone:310-303-7561
Practice Address - Fax:310-303-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050353OtherOLD TIN AND BX PROV#
CAHSC30353FMedicaid
CAHST30353FMedicaid
CACGP00180Medicaid
CAZZT30353FMedicaid
CAZZT40353FMedicaid
CAZZZA1934ZOtherOLD TIN & BS PROV#
CAHST30353FMedicaid
CAHSC30353FMedicaid
CA050353AMedicare UPIN
CAZZT40353FMedicaid