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NPI Code Detail

MEDICARE: SUMMER BREEZE HOSPICE AND PALLIATIVE CARE, INC.

MEDICARE: SUMMER BREEZE HOSPICE AND 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
1251G00000XCommunity Based Hospice Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11396156832OTHERCANPI

General Provider Information

NPI Number : 1396156832
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMER BREEZE HOSPICE AND PALLIATIVE CARE, INC.
Provider Business Mailing Address
First Line : 609 W BEVERLY BLVD
Second Line : SUITE A
City : MONTEBELLO
State : CA
Zip : 90640-3623
Country : US
Telephone Number : 323-483-5078
Fax Number : 323-978-1632
Provider Business Practice Location Address
First Line : 609 W BEVERLY BLVD
Second Line : SUITE A
City : MONTEBELLO
State : CA
Zip : 90640-3623
Country : US
Telephone Number : 323-483-5078
Fax Number : 323-978-1632
Authorized Official
Title or Position : PRESIDENT / CEO
Name : WELLINGTON CARLOS JR.
Credential :
Telephone Number : 213-494-8761
Provider Enumeration Date : 05/19/2014
Last Update Date : 08/07/2021

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Directions to “SUMMER BREEZE HOSPICE AND PALLIATIVE CARE, INC. ” Practice Location

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