Provider Demographics
NPI:1710569728
Name:O2 HOSPICE, INC.
Entity Type:Organization
Organization Name:O2 HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOVHANNES
Authorized Official - Middle Name:
Authorized Official - Last Name:OSIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-800-0803
Mailing Address - Street 1:19634 VENTURA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-7106
Mailing Address - Country:US
Mailing Address - Phone:323-800-0803
Mailing Address - Fax:323-800-0883
Practice Address - Street 1:19634 VENTURA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-7106
Practice Address - Country:US
Practice Address - Phone:323-800-0803
Practice Address - Fax:323-800-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2021Medicaid