| NPI | 1043406440 |
|---|---|
| Doing Business As | PROVIDENCE ST. MARY MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | RANDALL CASTILLO Chief Executive 760-946-8195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: CA NMW1225) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2020-12-16 |