Provider Demographics
NPI:1578541496
Name:LOS ANGELES HOSPICE INC
Entity Type:Organization
Organization Name:LOS ANGELES HOSPICE INC
Other - Org Name:LA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMABEL
Authorized Official - Middle Name:NOCEDA
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:213-351-1030
Mailing Address - Street 1:3580 WILSHIRE BLVD STE 1290
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2514
Mailing Address - Country:US
Mailing Address - Phone:213-351-1030
Mailing Address - Fax:213-351-1032
Practice Address - Street 1:3580 WILSHIRE BLVD STE 1290
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2514
Practice Address - Country:US
Practice Address - Phone:213-351-1030
Practice Address - Fax:213-351-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001542251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01766FOtherMEDI-CAL ID#
CA051766Medicare ID - Type UnspecifiedMEDICARE ID#