=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427529122
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SINCERE HOSPICE AND PALLIATIVE CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2018
-----------------------------------------------------
Last Update Date | 12/07/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12881 KNOTT ST STE 234
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-3943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 657-667-4111
-----------------------------------------------------
Fax | 657-234-2637
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12881 KNOTT ST STE 234
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-3943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 657-667-4111
-----------------------------------------------------
Fax | 657-234-2637
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | ISAURO M AGUSTIN JR.
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 714-869-6302
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WH1000X
-----------------------------------------------------
Taxonomy Name | Hospice Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------