Provider Demographics
NPI:1457688954
Name:SEASONS HOSPICE & PALLIATIVE CARE OF CALIFORNIA- SAN DIEGO, LLC
Entity Type:Organization
Organization Name:SEASONS HOSPICE & PALLIATIVE CARE OF CALIFORNIA- SAN DIEGO, LLC
Other - Org Name:ACCENTCARE HOSPICE & PALLIATIVE CARE OF CALIFORNIA -SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP LEGAL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SISCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-221-0465
Mailing Address - Street 1:6400 SHAFER CT
Mailing Address - Street 2:STE 700
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16745 W BERNARDO DR
Practice Address - Street 2:STE 240
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1907
Practice Address - Country:US
Practice Address - Phone:877-643-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551550Medicare Oscar/Certification