MEDICARE: OPTIMAL HOSPICE, 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	251G00000X	Community Based Hospice Care Agency	070000581	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	070000581	OTHER	CA	HOSPICE LICENSE NUMBER

General Provider Information

NPI Number	:	1396726493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL HOSPICE, INC.

Provider Business Mailing Address
First Line	:	1227 CHESTER AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5445
Country	:	US
Telephone Number	:	661-410-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 CALIFORNIA AVE STE 110A
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-7024
Country	:	US
Telephone Number	:	661-716-4000
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP/CFO
Name	:	GERRY NORMAN CHRISTENSEN
Credential	:
Telephone Number	:	801-433-0932

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	04/25/2023

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Directions to “OPTIMAL HOSPICE, INC. ” Practice Location

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