Provider Demographics
NPI:1255673471
Name:GRACE PALLIATIVE AND COMPREHENSIVE CARE, INC.
Entity Type:Organization
Organization Name:GRACE PALLIATIVE AND COMPREHENSIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SEUNG-HO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-989-1600
Mailing Address - Street 1:1711 W TEMPLE ST
Mailing Address - Street 2:SUITE 3614
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-5421
Mailing Address - Country:US
Mailing Address - Phone:213-989-1600
Mailing Address - Fax:213-989-1626
Practice Address - Street 1:1711 W TEMPLE ST
Practice Address - Street 2:SUITE 3614
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5421
Practice Address - Country:US
Practice Address - Phone:213-989-1600
Practice Address - Fax:213-989-1626
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRACE HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001586251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01794FMedicaid