Provider Demographics
NPI:1508468539
Name:PEACEFUL PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:PEACEFUL PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-798-7019
Mailing Address - Street 1:8400 MIRAMAR RD STE 243C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4387
Mailing Address - Country:US
Mailing Address - Phone:619-798-7019
Mailing Address - Fax:
Practice Address - Street 1:8400 MIRAMAR RD STE 243C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4387
Practice Address - Country:US
Practice Address - Phone:619-798-7019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based