MEDICARE: LOMA LINDA HOSPICE CARE, 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

General Provider Information

NPI Number	:	1699173310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOMA LINDA HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	7301 MEDICAL CENTER DR STE 302
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1975
Country	:	US
Telephone Number	:	714-882-1135
Fax Number	:	714-882-1137

Provider Business Practice Location Address
First Line	:	7301 MEDICAL CENTER DR STE 302
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1975
Country	:	US
Telephone Number	:	714-882-1135
Fax Number	:	714-882-1137

Authorized Official
Title or Position	:	CEO
Name	:	MONIQUE NIETO
Credential	:
Telephone Number	:	714-882-1135

Provider Enumeration Date	:	12/11/2014
Last Update Date	:	05/22/2024

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