NOVA MEDICAL CENTER, A PROFESSIONAL CORPORATION
NPI 1154634228
Non-Pharmacy Dispensing Site in San Pedro, CA

Q: What is the provider's specialty?

The provider's specialty is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Active since July 19, 2010

1423 W 8TH ST, SAN PEDRO, CA 90732(818) 599-1002 Get Directions Write a Review

NPPES record last updated: April 3, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 3, 2019, Nov 16, 2018 (2 updates tracked since 2018).

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NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Non-Pharmacy Dispensing Site

About NOVA MEDICAL CENTER, A PROFESSIONAL CORPORATION

This page provides the complete NPI Profile along with additional information for Nova Medical Center, A Professional Corporation, a provider established in San Pedro, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1154634228 assigned on July 2010. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Randall Caldron Md (Medical Director)

NPI: 1154634228 Verify this NPI
Provider Name: NOVA MEDICAL CENTER, A PROFESSIONAL CORPORATION
Entity Type: Organization
Location Address: 1423 W 8TH ST SAN PEDRO, CA 90732
Location Phone: (818) 599-1002
Mailing Address: 1197 E LOS ANGELES AVE STE C303 SIMI VALLEY, CA 93065
Mailing Phone: (805) 501-6685
Mailing Fax: (866) 472-9836
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 07-19-2010
Last Update Date: 04-03-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Non-Pharmacy Dispensing Site
Taxonomy Code: 332900000X
Type: Suppliers
Taxonomy Description: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: RANDALL CALDRON MD
Authorized Official Title: MEDICAL DIRECTOR
Authorized Official Phone: (818) 599-1002