=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578541496
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOS ANGELES HOSPICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2006
-----------------------------------------------------
Last Update Date | 05/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3580 WILSHIRE BLVD STE 1290
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90010-2514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-351-1030
-----------------------------------------------------
Fax | 213-351-1032
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3580 WILSHIRE BLVD STE 1290
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90010-2514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-351-1030
-----------------------------------------------------
Fax | 213-351-1032
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. AMABEL NOCEDA SARMIENTO
-----------------------------------------------------
Credential | LVN
-----------------------------------------------------
Telephone | 213-351-1030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 980001542
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------