Provider Demographics
NPI:1710575998
Name:GOLDEN STATE HOSPICE CARE
Entity Type:Organization
Organization Name:GOLDEN STATE HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALAFIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-940-1258
Mailing Address - Street 1:4405 W RIVERSIDE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4050
Mailing Address - Country:US
Mailing Address - Phone:818-940-1258
Mailing Address - Fax:818-847-7966
Practice Address - Street 1:4405 W RIVERSIDE DR STE 203
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4050
Practice Address - Country:US
Practice Address - Phone:818-940-1258
Practice Address - Fax:818-847-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based