MEDICARE: MONARCH HOSPICE CARE, 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

General Provider Information

NPI Number	:	1205258126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	19608 CAMINO DE ROSA STE 201
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-2103
Country	:	US
Telephone Number	:	626-318-2381
Fax Number	:	909-595-1211

Provider Business Practice Location Address
First Line	:	19608 CAMINO DE ROSA STE 201
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-2103
Country	:	US
Telephone Number	:	626-318-2381
Fax Number	:	909-595-1211

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. DEANNA MAY SAN DIEGO
Credential	:	RN
Telephone Number	:	626-318-2381

Provider Enumeration Date	:	01/11/2014
Last Update Date	:	01/11/2014

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