Healthcare Provider Details

I. General information

NPI: 1942075437
Provider Name (Legal Business Name): MAJESTIC PALLIATIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16360 MONTEREY ST STE 140
MORGAN HILL CA
95037-5454
US

IV. Provider business mailing address

16360 MONTEREY ST STE 140
MORGAN HILL CA
95037-5454
US

V. Phone/Fax

Practice location:
  • Phone: 408-779-0100
  • Fax: 408-779-0300
Mailing address:
  • Phone: 408-779-0100
  • Fax: 408-779-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALI WARRIACH
Title or Position: PRESIDENT
Credential:
Phone: 408-779-0100