Healthcare Provider Details

I. General information

NPI: 1609149491
Provider Name (Legal Business Name): HUNTINGTON PALLIATIVE MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

PO BOX 67065
LOS ANGELES CA
90067-0065
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-3737
  • Fax:
Mailing address:
  • Phone: 310-273-7365
  • Fax: 310-273-7366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA99921
License Number StateCA

VIII. Authorized Official

Name: DR. DANIEL R SPURGEON
Title or Position: PRESIDENT
Credential: MD
Phone: 310-273-7365