Healthcare Provider Details

I. General information

NPI: 1336715309
Provider Name (Legal Business Name): ZILLA HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 COLORADO BLVD STE 250B
LOS ANGELES CA
90041-2357
US

IV. Provider business mailing address

1480 COLORADO BLVD STE 250B
LOS ANGELES CA
90041-2357
US

V. Phone/Fax

Practice location:
  • Phone: 818-227-8970
  • Fax: 818-227-8973
Mailing address:
  • Phone: 818-227-8970
  • Fax: 818-227-8973

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: TIRAN ATOYAN
Title or Position: CEO
Credential:
Phone: 818-227-8970