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General NPI Number Information
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NPI Number | 1508362690
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Entity Type | Organization
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Legal Business Name | HOSPICE PBM INC
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 3000 N HOLLYWOOD WAY FL 2
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City | BURBANK
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State | CA
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Zip | 91505-1026
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Country | US
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Telephone | 818-786-3110
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Fax | 818-786-3150
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Provider Business Mailing Address
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Address Line | 16525 SHERMAN WAY STE C1
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City | VAN NUYS
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State | CA
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Zip | 91406-3753
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Country | US
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Telephone | 818-786-3110
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Fax | 818-786-3150
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. JENSEN CHANG
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Credential | PHARM.D.
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Telephone | 818-786-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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