MEDICARE: CARDINAL HOSPICE AND PALLIATIVE 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	:	1972129641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDINAL HOSPICE AND PALLIATIVE CARE

Provider Business Mailing Address
First Line	:	500 N PALM AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-3218
Country	:	US
Telephone Number	:	909-395-9676
Fax Number	:	909-395-9687

Provider Business Practice Location Address
First Line	:	500 N PALM AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-3218
Country	:	US
Telephone Number	:	909-395-9676
Fax Number	:	909-395-9687

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	GLODILYN BADILLA MANCILLA-ALMARIO
Credential	:
Telephone Number	:	909-529-3138

Provider Enumeration Date	:	06/18/2020
Last Update Date	:	09/29/2022

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