Provider Demographics
NPI:1609960897
Name:DAIAN CORPORATION
Entity Type:Organization
Organization Name:DAIAN CORPORATION
Other - Org Name:PEC HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:LU
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-590-3620
Mailing Address - Street 1:10507 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1128
Mailing Address - Country:US
Mailing Address - Phone:714-689-2300
Mailing Address - Fax:714-689-2301
Practice Address - Street 1:10507 GARDEN GROVE BLVD # F
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1128
Practice Address - Country:US
Practice Address - Phone:714-689-2300
Practice Address - Fax:714-689-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001495251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01611GMedicaid
CA051611Medicare Oscar/Certification