Healthcare Provider Details

I. General information

NPI: 1568136380
Provider Name (Legal Business Name): FIDELITY HOSPICE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4854 VAN NUYS BLVD STE 210
SHERMAN OAKS CA
91403-2114
US

IV. Provider business mailing address

4854 VAN NUYS BLVD STE 210
SHERMAN OAKS CA
91403-2114
US

V. Phone/Fax

Practice location:
  • Phone: 747-345-3062
  • Fax: 747-345-3063
Mailing address:
  • Phone: 747-345-3062
  • Fax: 747-345-3063

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: ARMINE BAKHTAMYAN
Title or Position: CEO
Credential:
Phone: 747-345-3062