MEDICARE: CALIFORNIA MISSION HOSPICE LLC

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	:	1457609380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA MISSION HOSPICE LLC

Provider Business Mailing Address
First Line	:	23441 S POINTE DR STE 245
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1552
Country	:	US
Telephone Number	:	949-829-9888
Fax Number	:	949-829-6888

Provider Business Practice Location Address
First Line	:	23441 S POINTE DR STE 245
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1552
Country	:	US
Telephone Number	:	949-829-9888
Fax Number	:	949-829-6888

Authorized Official
Title or Position	:	MEMBER
Name	:	CYNTHIA JAMLANG
Credential	:
Telephone Number	:	949-829-9888

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	10/29/2019

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