Healthcare Provider Details

I. General information

NPI: 1205810769
Provider Name (Legal Business Name): PASADENA HOSPICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 S ROSEMEAD BLVD #5 STE 5
PASADENA CA
91107-4931
US

IV. Provider business mailing address

408 S ROSEMEAD BLVD #5 STE 5
PASADENA CA
91107-4931
US

V. Phone/Fax

Practice location:
  • Phone: 626-398-0195
  • Fax: 626-398-0113
Mailing address:
  • Phone: 626-398-0195
  • Fax: 626-398-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number251G00000X
License Number StateCA

VIII. Authorized Official

Name: MR. RALPH CANALES
Title or Position: BSN
Credential:
Phone: 626-398-0195