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General NPI Number Information
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NPI Number | 1063090181
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Entity Type | Organization
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Legal Business Name | MG HOSPICE INC
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 8815 RESEDA BLVD # F
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4040
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Country | US
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Telephone | 747-224-6991
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Fax | 747-252-5438
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Provider Business Mailing Address
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Address Line | 8815 RESEDA BLVD # F
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4040
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Country | US
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Telephone | 747-224-6991
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Fax | 747-252-5438
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Authorized Official
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Title or Position | CEO
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Name | MR. GAREGIN MIKAELYAN
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Credential |
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Telephone | 323-401-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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