MEDICARE: ANGELS HOSPICE, LLC

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	:	1972749075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS HOSPICE, LLC

Provider Business Mailing Address
First Line	:	19830 LAKE CHABOT RD STE B
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4063
Country	:	US
Telephone Number	:	510-727-9000
Fax Number	:	510-727-9832

Provider Business Practice Location Address
First Line	:	19830 LAKE CHABOT RD STE B
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4063
Country	:	US
Telephone Number	:	510-727-9000
Fax Number	:	510-727-9832

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AREZOU DADGAR
Credential	:	R.N
Telephone Number	:	510-727-9000

Provider Enumeration Date	:	12/20/2008
Last Update Date	:	04/21/2022

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Directions to “ANGELS HOSPICE, LLC ” Practice Location

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