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General NPI Number Information
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NPI Number | 1235282773
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Entity Type | Organization
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Legal Business Name | PACIFIC HOSPICE CARE CORPORATION
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2520 W 6TH ST 201
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City | LOS ANGELES
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State | CA
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Zip | 90057-3174
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Country | US
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Telephone | 213-382-3835
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 W 6TH ST 201
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City | LOS ANGELES
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State | CA
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Zip | 90057-3174
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ZAKHAR VAYNEROV
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Credential |
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Telephone | 213-382-3835
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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 | CA
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