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General NPI Number Information
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NPI Number | 1730163148
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Entity Type | Organization
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Legal Business Name | PACIFIC HOSPICE CARE CORPORATION
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 17141 VENTURA BLVD STE 201
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City | ENCINO
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State | CA
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Zip | 91316-4038
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Country | US
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Telephone | 213-382-3825
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Fax | 213-826-1664
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Provider Business Mailing Address
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Address Line | 17141 VENTURA BLVD STE 201
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City | ENCINO
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State | CA
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Zip | 91316-4038
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Country | US
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Telephone | 213-382-3825
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Fax | 213-386-1664
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Authorized Official
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Title or Position | CEO
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Name | ALEXANDER BOYM
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Credential |
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Telephone | 213-382-3835
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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 | 980001560
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License Number State | CA
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