Provider Demographics
NPI:1851820732
Name:GOLDEN DIAMOND HOSPICE, INC
Entity Type:Organization
Organization Name:GOLDEN DIAMOND HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:TABEQUERO
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-396-1025
Mailing Address - Street 1:11385 183RD ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5434
Mailing Address - Country:US
Mailing Address - Phone:562-396-1025
Mailing Address - Fax:562-468-0889
Practice Address - Street 1:11385 183RD ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5434
Practice Address - Country:US
Practice Address - Phone:562-396-1025
Practice Address - Fax:562-468-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based