Healthcare Provider Details

I. General information

NPI: 1730409806
Provider Name (Legal Business Name): ANGELS HOSPICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15220 CENTRAL AVENUE UNIT B
CHINO CA
91710-7657
US

IV. Provider business mailing address

15220 CENTRAL AVENUE UNIT B
CHINO CA
91710-7657
US

V. Phone/Fax

Practice location:
  • Phone: 909-393-1000
  • Fax: 909-393-8823
Mailing address:
  • Phone: 909-393-1000
  • Fax: 909-393-8823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MR. EDMERAL JOHN DE GUZMAN
Title or Position: CEO
Credential:
Phone: 909-393-1000