Healthcare Provider Details

I. General information

NPI: 1043817810
Provider Name (Legal Business Name): KNH HOSPICE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E WILSON AVE STE 100
GLENDALE CA
91206-4374
US

IV. Provider business mailing address

520 E WILSON AVE STE 100
GLENDALE CA
91206-4374
US

V. Phone/Fax

Practice location:
  • Phone: 310-906-7703
  • Fax:
Mailing address:
  • Phone: 310-906-7703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARAT DURYAN
Title or Position: CEO
Credential:
Phone: 310-906-7703