Provider Demographics
NPI:1417579285
Name:ALTA HOSPICE OF CALIFORNIA
Entity Type:Organization
Organization Name:ALTA HOSPICE OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NAREG
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVASARTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:866-935-5055
Mailing Address - Street 1:1898 N ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4114
Mailing Address - Country:US
Mailing Address - Phone:866-935-5055
Mailing Address - Fax:866-935-5055
Practice Address - Street 1:1898 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4114
Practice Address - Country:US
Practice Address - Phone:866-935-5055
Practice Address - Fax:866-935-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based