Healthcare Provider Details

I. General information

NPI: 1407856487
Provider Name (Legal Business Name): PACIFIC HOSPICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1998 N ARROWHEAD AVE
SAN BERNARDINO CA
92405-4116
US

IV. Provider business mailing address

1998 N ARROWHEAD AVE
SAN BERNARDINO CA
92405-4116
US

V. Phone/Fax

Practice location:
  • Phone: 909-882-8466
  • Fax: 909-882-9203
Mailing address:
  • Phone: 909-882-8466
  • Fax: 909-882-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number080000790
License Number StateCA

VIII. Authorized Official

Name: DR. SUNIL ARORA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 909-882-8466