Healthcare Provider Details

I. General information

NPI: 1699381236
Provider Name (Legal Business Name): MALIBU HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 ALONZO AVE
ENCINO CA
91316-4308
US

IV. Provider business mailing address

4301 ALONZO AVE
ENCINO CA
91316-4308
US

V. Phone/Fax

Practice location:
  • Phone: 424-325-8231
  • Fax:
Mailing address:
  • Phone: 424-325-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: DAVID ARUSHANYAN
Title or Position: CEO
Credential:
Phone: 424-325-8231