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General NPI Number Information
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NPI Number | 1730409806
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Entity Type | Organization
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Legal Business Name | ANGELS HOSPICE CORPORATION
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 15220 CENTRAL AVENUE UNIT B
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City | CHINO
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State | CA
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Zip | 91710-7657
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Country | US
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Telephone | 909-393-1000
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Fax | 909-393-8823
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Provider Business Mailing Address
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Address Line | 15220 CENTRAL AVENUE UNIT B
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City | CHINO
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State | CA
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Zip | 91710-7657
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Country | US
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Telephone | 909-393-1000
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Fax | 909-393-8823
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Authorized Official
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Title or Position | CEO
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Name | MR. EDMERAL JOHN DE GUZMAN
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Credential |
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Telephone | 909-393-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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