Healthcare Provider Details

I. General information

NPI: 1699323709
Provider Name (Legal Business Name): EZRA HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S SAN GABRIEL BLVD STE A
SAN GABRIEL CA
91776-1966
US

IV. Provider business mailing address

405 S SAN GABRIEL BLVD STE A
SAN GABRIEL CA
91776-1966
US

V. Phone/Fax

Practice location:
  • Phone: 888-820-2880
  • Fax: 818-738-7282
Mailing address:
  • Phone: 888-820-2880
  • Fax: 818-738-7282

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: JOCELYN ONGPICO
Title or Position: CEO
Credential:
Phone: 888-820-2880