Provider Demographics
NPI:1386867141
Name:VICTORIA HOSPICE SERVICES, INC
Entity Type:Organization
Organization Name:VICTORIA HOSPICE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUBASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:323-653-0544
Mailing Address - Street 1:8797 BEVERLY BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1862
Mailing Address - Country:US
Mailing Address - Phone:323-653-0544
Mailing Address - Fax:323-653-3880
Practice Address - Street 1:8797 BEVERLY BLVD STE 310
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1862
Practice Address - Country:US
Practice Address - Phone:323-653-0544
Practice Address - Fax:510-991-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001459251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based