Provider Demographics
NPI:1033888151
Name:OCEAN BREEZE HOSPICE & PALLITIVE CARE CORP.
Entity Type:Organization
Organization Name:OCEAN BREEZE HOSPICE & PALLITIVE CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-212-7978
Mailing Address - Street 1:227 CAMINO CALAFIA
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-9738
Mailing Address - Country:US
Mailing Address - Phone:760-212-7978
Mailing Address - Fax:
Practice Address - Street 1:227 CAMINO CALAFIA
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-9738
Practice Address - Country:US
Practice Address - Phone:760-212-7978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-11
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAPPLYINGOtherAPPLYING