Healthcare Provider Details

I. General information

NPI: 1437701646
Provider Name (Legal Business Name): PRISTINE HOSPICE AND PALLIATIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14081 YORBA ST STE 106
TUSTIN CA
92780-2050
US

IV. Provider business mailing address

14081 YORBA ST STE 106
TUSTIN CA
92780-2050
US

V. Phone/Fax

Practice location:
  • Phone: 714-603-7451
  • Fax:
Mailing address:
  • Phone: 714-603-7451
  • Fax: 714-603-7213

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: MR. FERNAN DAVID
Title or Position: PRESIDENT
Credential:
Phone: 714-603-7451