Provider Demographics
NPI:1093250292
Name:SEA COAST HOSPICE CARE INC
Entity Type:Organization
Organization Name:SEA COAST HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVRANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-452-9300
Mailing Address - Street 1:8380 MIRAMAR MALL
Mailing Address - Street 2:STE 109
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2548
Mailing Address - Country:US
Mailing Address - Phone:858-452-9300
Mailing Address - Fax:858-452-6300
Practice Address - Street 1:8380 MIRAMAR MALL
Practice Address - Street 2:STE 109
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2548
Practice Address - Country:US
Practice Address - Phone:858-452-9300
Practice Address - Fax:858-452-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based