MEDICARE: GRACE 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	:	1588722771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE HOSPICE INC

Provider Business Mailing Address
First Line	:	1711 W TEMPLE ST
Second Line	:	SUITE # 3614
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-5421
Country	:	US
Telephone Number	:	213-989-1600
Fax Number	:	213-989-1626

Provider Business Practice Location Address
First Line	:	1711 W TEMPLE ST
Second Line	:	SUITE # 3614
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-5421
Country	:	US
Telephone Number	:	213-989-1600
Fax Number	:	213-989-1626

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	DR. SEUNG HO CHOI
Credential	:	M.D.
Telephone Number	:	213-989-1600

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	08/22/2020

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Directions to “GRACE HOSPICE INC ” Practice Location

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