Provider Demographics
NPI:1952480170
Name:TORRANCE MEMORIAL MEDICAL CENTER
Entity Type:Organization
Organization Name:TORRANCE MEMORIAL MEDICAL CENTER
Other - Org Name:TORRANCE MEMORIAL HOME HEALTH & HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:310-784-3739
Mailing Address - Street 1:23326 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3725
Mailing Address - Country:US
Mailing Address - Phone:310-784-3751
Mailing Address - Fax:310-784-3717
Practice Address - Street 1:23326 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 100 B
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3725
Practice Address - Country:US
Practice Address - Phone:310-784-3751
Practice Address - Fax:310-784-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000483251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01615FMedicaid
CAZZZ05141ZOtherBLUE SHIELD
CA051615Medicare Oscar/Certification