MEDICARE: MAJESTY HOSPICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093792996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJESTY HOSPICE, INC.

Provider Business Mailing Address
First Line	:	4221 WILSHIRE BLVD
Second Line	:	STE 480
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3512
Country	:	US
Telephone Number	:	323-634-9907
Fax Number	:	323-634-9906

Provider Business Practice Location Address
First Line	:	4221 WILSHIRE BLVD
Second Line	:	STE 480
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3512
Country	:	US
Telephone Number	:	323-634-9907
Fax Number	:	323-634-9906

Authorized Official
Title or Position	:	PRES / CEO
Name	:	MISS MARY ALYN ABAD DOMONDON
Credential	:	RN
Telephone Number	:	323-819-1472

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	08/22/2020

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Directions to “MAJESTY HOSPICE, INC. ” Practice Location

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