Provider Demographics
NPI:1659781045
Name:SOJOURN HOSPICE & PALLIATIVE CARE - SAN DIEGO LLC
Entity Type:Organization
Organization Name:SOJOURN HOSPICE & PALLIATIVE CARE - SAN DIEGO LLC
Other - Org Name:BRISTOL HOSPICE - SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURICIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-325-0175
Mailing Address - Street 1:8765 AERO DR STE 226
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1767
Mailing Address - Country:US
Mailing Address - Phone:858-217-2468
Mailing Address - Fax:
Practice Address - Street 1:8765 AERO DR STE 226
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1767
Practice Address - Country:US
Practice Address - Phone:858-217-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based