Provider Demographics
NPI:1073024691
Name:MEGA HOSPICE CARE
Entity Type:Organization
Organization Name:MEGA HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASADOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PONCHUKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-494-1041
Mailing Address - Street 1:12235 BEACH BLVD STE 200G
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3964
Mailing Address - Country:US
Mailing Address - Phone:714-494-1041
Mailing Address - Fax:714-468-5114
Practice Address - Street 1:12235 BEACH BLVD STE 200G
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-3964
Practice Address - Country:US
Practice Address - Phone:714-494-1041
Practice Address - Fax:714-468-5114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based