Provider Demographics
NPI:1255478251
Name:MHIRAMARC MANAGEMENT LLC
Entity Type:Organization
Organization Name:MHIRAMARC MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-927-2320
Mailing Address - Street 1:8050 FLORENCE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3834
Mailing Address - Country:US
Mailing Address - Phone:562-927-2320
Mailing Address - Fax:562-927-2322
Practice Address - Street 1:8050 FLORENCE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3834
Practice Address - Country:US
Practice Address - Phone:562-927-2320
Practice Address - Fax:562-927-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000482163WH1000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551547Medicare Oscar/Certification