MEDICARE: STARLIGHT 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
2	251G00000X	Community Based Hospice Care Agency	550002977	CA

General Provider Information

NPI Number	:	1659780716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARLIGHT HOSPICE INC

Provider Business Mailing Address
First Line	:	4959 PALO VERDE ST STE 102B
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-2339
Country	:	US
Telephone Number	:	909-399-3600
Fax Number	:	909-399-3605

Provider Business Practice Location Address
First Line	:	738 N EUCLID AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-2712
Country	:	US
Telephone Number	:	951-663-2257
Fax Number	:	909-399-3605

Authorized Official
Title or Position	:	REPRESENTATIVE
Name	:	VIVIAN GONZALES
Credential	:
Telephone Number	:	909-399-3600

Provider Enumeration Date	:	08/03/2014
Last Update Date	:	06/10/2025

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Directions to “STARLIGHT HOSPICE INC ” Practice Location

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