Provider Demographics
NPI:1477134781
Name:EL PRIMERO HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:EL PRIMERO HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDVARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-737-3127
Mailing Address - Street 1:7335 VAN NUYS BLVD STE 223
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1998
Mailing Address - Country:US
Mailing Address - Phone:747-737-3127
Mailing Address - Fax:747-737-3128
Practice Address - Street 1:7335 VAN NUYS BLVD STE 223
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1998
Practice Address - Country:US
Practice Address - Phone:747-737-3127
Practice Address - Fax:747-737-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based