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General NPI Number Information
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NPI Number | 1922558287
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Entity Type | Organization
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Legal Business Name | COMPASSUS OP OF CALIFORNIA LLC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 3110 W LAKE CENTER DR
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City | SANTA ANA
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State | CA
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Zip | 92704-6917
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Country | US
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Telephone | 714-445-0407
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Fax | 855-212-0422
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Provider Business Mailing Address
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Address Line | 3110 W LAKE CENTER DR
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City | SANTA ANA
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State | CA
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Zip | 92704-6917
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Country | US
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Telephone | 714-445-0407
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Fax | 855-212-0422
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY JAMES
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Credential |
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Telephone | 615-224-8028
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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 |
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License Number State |
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