=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861072050
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALIFORNIA ANGELS HOSPICE AND PALLIATIVE CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2021
-----------------------------------------------------
Last Update Date | 05/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5250 LANKERSHIM BLVD STE.# 523
-----------------------------------------------------
City | NORTH HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-300-0763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5250 LANKERSHIM BLVD STE.# 523
-----------------------------------------------------
City | NORTH HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CFO
-----------------------------------------------------
Name | GAYANE MANUKYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 747-300-0763
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------