MEDICARE: GRACE PALLIATIVE AND HOSPICE CARE

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	:	1720602790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE PALLIATIVE AND HOSPICE CARE

Provider Business Mailing Address
First Line	:	8119 FOOTHILL BLVD STE 5
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-3600
Country	:	US
Telephone Number	:	747-282-1898
Fax Number	:	747-282-1899

Provider Business Practice Location Address
First Line	:	8119 FOOTHILL BLVD STE 5
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-3600
Country	:	US
Telephone Number	:	747-282-1898
Fax Number	:	747-282-1899

Authorized Official
Title or Position	:	CEO
Name	:	MELIK GOZALIAN
Credential	:
Telephone Number	:	747-282-1898

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	06/04/2020

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Directions to “GRACE PALLIATIVE AND HOSPICE CARE ” Practice Location

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