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General NPI Number Information
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NPI Number | 1316238835
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Entity Type | Organization
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Legal Business Name | WESTSIDE HOSPICE COMFORTCARE INCORPORATION
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 9555 W. PICO BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90035-1215
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Country | US
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Telephone | 310-284-6637
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Fax | 310-284-8014
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Provider Business Mailing Address
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Address Line | 9555 W. PICO BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90035-1215
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Country | US
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Telephone | 310-284-6637
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Fax | 310-284-8014
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Authorized Official
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Title or Position | CEO/CFO
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Name | MRS. ANNA GEVORKIAN
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Credential |
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Telephone | 310-284-6637
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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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