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General NPI Number Information
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NPI Number | 1699931337
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Entity Type | Organization
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Legal Business Name | EXCELLENT CARE HOSPICE, INC.
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 660 N DIAMOND BAR BLVD STE 206
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1008
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Country | US
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Telephone | 909-860-3388
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Fax | 909-860-3988
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Provider Business Mailing Address
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Address Line | 660 N DIAMOND BAR BLVD STE 206
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1008
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Country | US
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Telephone | 909-860-3388
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Fax | 909-860-3988
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | DR. REYNALDO FERNANDEZ
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Credential | D.M.D.
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Telephone | 909-860-3388
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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 | 980001630
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License Number State | CA
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