Provider Demographics
NPI:1366023210
Name:CHERRY BLOSSOM HOSPICE CARE
Entity Type:Organization
Organization Name:CHERRY BLOSSOM HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-895-5147
Mailing Address - Street 1:2930 HONOLULU AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3979
Mailing Address - Country:US
Mailing Address - Phone:747-895-5147
Mailing Address - Fax:
Practice Address - Street 1:2930 HONOLULU AVE STE 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91214-3979
Practice Address - Country:US
Practice Address - Phone:747-895-5147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based