Healthcare Provider Details

I. General information

NPI: 1295303311
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16830 VENTURA BLVD STE 315
ENCINO CA
91436-1723
US

IV. Provider business mailing address

3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US

V. Phone/Fax

Practice location:
  • Phone: 818-385-0273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS WESTFALL
Title or Position: CEO
Credential:
Phone: 513-618-2230