MEDICARE: LOS ANGELES 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	980001542	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HPC01766F	OTHER	CA	MEDI-CAL ID#

General Provider Information

NPI Number	:	1578541496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES HOSPICE INC

Provider Business Mailing Address
First Line	:	3580 WILSHIRE BLVD STE 1290
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2514
Country	:	US
Telephone Number	:	213-351-1030
Fax Number	:	213-351-1032

Provider Business Practice Location Address
First Line	:	3580 WILSHIRE BLVD STE 1290
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2514
Country	:	US
Telephone Number	:	213-351-1030
Fax Number	:	213-351-1032

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. AMABEL NOCEDA SARMIENTO
Credential	:	LVN
Telephone Number	:	213-351-1030

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	05/12/2020

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Directions to “LOS ANGELES HOSPICE INC ” Practice Location

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