MEDICARE: ST DYLAN 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

General Provider Information

NPI Number	:	1730786948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST DYLAN HOSPICE INC

Provider Business Mailing Address
First Line	:	1827 W VERDUGO AVE UNIT 208
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-2151
Country	:	US
Telephone Number	:	747-301-4257
Fax Number	:	747-262-1681

Provider Business Practice Location Address
First Line	:	1827 W VERDUGO AVE UNIT 208
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-2151
Country	:	US
Telephone Number	:	747-301-4257
Fax Number	:	747-262-1681

Authorized Official
Title or Position	:	OWNER
Name	:	AVETIS DENNY BEKARIAN
Credential	:
Telephone Number	:	747-301-4257

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	07/27/2021

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Directions to “ST DYLAN HOSPICE INC ” Practice Location

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