Provider Demographics
NPI:1588009088
Name:STARLINE HOSPICE, INC.
Entity Type:Organization
Organization Name:STARLINE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:XUANRU
Authorized Official - Middle Name:
Authorized Official - Last Name:JIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-674-7555
Mailing Address - Street 1:3053 W OLYMPIC BLVD STE 207A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2558
Mailing Address - Country:US
Mailing Address - Phone:213-674-7555
Mailing Address - Fax:213-674-7995
Practice Address - Street 1:3053 W OLYMPIC BLVD STE 207A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2558
Practice Address - Country:US
Practice Address - Phone:213-674-7555
Practice Address - Fax:213-674-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002796251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA751685OtherMEDICARE