Provider Demographics
NPI:1629190558
Name:HOSPICE SPECIALIST INCORPORATED
Entity Type:Organization
Organization Name:HOSPICE SPECIALIST INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-493-6299
Mailing Address - Street 1:3486 FELA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3209
Mailing Address - Country:US
Mailing Address - Phone:562-493-6299
Mailing Address - Fax:
Practice Address - Street 1:3486 FELA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3209
Practice Address - Country:US
Practice Address - Phone:562-493-6299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6406207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A6406OtherSTATE LICENSE NUMBER