=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518322593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH COUNTY HOSPICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/17/2015
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32332 CAMINO CAPISTRANO STE 201
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-345-3267
-----------------------------------------------------
Fax | 949-656-7721
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32332 CAMINO CAPISTRANO STE 201
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-345-3267
-----------------------------------------------------
Fax | 949-656-7721
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DAVID EDWARD SPENCER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 760-809-5867
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------