MEDICARE: SPRING HOPE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C4634705	OTHER	CA	CALIFORNIA ENTITY NUMBER

General Provider Information

NPI Number	:	1497353817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING HOPE HOSPICE, INC.

Provider Business Mailing Address
First Line	:	14718 PIPELINE AVE STE C
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1299
Country	:	US
Telephone Number	:	562-404-8883
Fax Number	:	562-404-8884

Provider Business Practice Location Address
First Line	:	14718 PIPELINE AVE STE C
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1299
Country	:	US
Telephone Number	:	562-404-8883
Fax Number	:	562-404-8884

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	HERMAWAN DJUHANA
Credential	:
Telephone Number	:	213-361-2888

Provider Enumeration Date	:	10/16/2020
Last Update Date	:	05/05/2026

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