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General NPI Number Information
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NPI Number | 1205060050
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Entity Type | Organization
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Legal Business Name | MAR VISTA HOSPICE INC
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 728 S HILL ST STE 1201
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City | LOS ANGELES
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State | CA
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Zip | 90014-2706
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Country | US
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Telephone | 213-627-3685
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Fax | 213-627-3689
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Provider Business Mailing Address
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Address Line | 728 S HILL ST STE 1201
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City | LOS ANGELES
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State | CA
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Zip | 90014-2706
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Country | US
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Telephone | 213-627-3685
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Fax | 213-627-3689
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Authorized Official
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Title or Position | COO
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Name | SHAKE J SARAFIAN
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Credential |
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Telephone | 213-627-3685
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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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