MEDICARE: ASTRID PALLIATIVE CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1285257493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRID PALLIATIVE CARE INC

Provider Business Mailing Address
First Line	:	2416 W VICTORY BLVD # 114
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1229
Country	:	US
Telephone Number	:	818-732-8272
Fax Number	:	818-732-8522

Provider Business Practice Location Address
First Line	:	2501 W BURBANK BLVD STE 200
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2347
Country	:	US
Telephone Number	:	818-732-8272
Fax Number	:	818-732-8522

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	HANA JALILI
Credential	:
Telephone Number	:	818-698-1400

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	05/21/2020

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