Healthcare Provider Details
I. General information
NPI: 1194869750
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/16/2007
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16830 VENTURA BLVD SUITE 315
ENCINO CA
91436-1707
US
IV. Provider business mailing address
3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US
V. Phone/Fax
- Phone: 818-385-0273
- Fax: 818-971-3580
- Phone: 305-374-4143
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 980000729 |
| License Number State | CA |
VIII. Authorized Official
Name:
NICHOLAS
WESTFALL
Title or Position: CEO
Credential:
Phone: 305-374-4143