Provider Demographics
NPI:1659049658
Name:MAJESTIC HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:MAJESTIC HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:FAZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-515-0304
Mailing Address - Street 1:10325 CRAFTSMAN WAY APT 207
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3528
Mailing Address - Country:US
Mailing Address - Phone:800-515-0304
Mailing Address - Fax:
Practice Address - Street 1:106 S GRAPE ST UNIT 5
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4407
Practice Address - Country:US
Practice Address - Phone:800-515-0304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based