Healthcare Provider Details
I. General information
NPI: 1558405134
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/16/2007
Last Update Date: 12/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2710 GATEWAY OAKS DR SUITE 100
SACRAMENTO CA
95833-3505
US
IV. Provider business mailing address
3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US
V. Phone/Fax
- Phone: 916-925-7010
- Fax: 916-566-2250
- Phone: 305-374-4143
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 100000774 |
| License Number State | CA |
VIII. Authorized Official
Name:
NICHOLAS
WESTFALL
Title or Position: CEO
Credential:
Phone: 305-374-4143