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NPI Code Detail

MEDICARE: MEDFAST HOSPICE CARE

MEDICARE: MEDFAST HOSPICE CARE
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

General Provider Information

NPI Number : 1487239851
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDFAST HOSPICE CARE
Provider Business Mailing Address
First Line : 7430 COLDWATER CANYON AVE STE D
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-3501
Country : US
Telephone Number : 747-444-6404
Fax Number :
Provider Business Practice Location Address
First Line : 7430 COLDWATER CANYON AVE STE D
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-3501
Country : US
Telephone Number : 747-444-6404
Fax Number :
Authorized Official
Title or Position : CEO
Name : GARIK BRUTYAN
Credential :
Telephone Number : 747-444-6404
Provider Enumeration Date : 03/16/2021
Last Update Date : 03/16/2021

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Directions to “MEDFAST HOSPICE CARE ” Practice Location

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