Provider Demographics
NPI:1932501814
Name:COMFORT CARE HOSPICE PROVIDERS
Entity Type:Organization
Organization Name:COMFORT CARE HOSPICE PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARDANPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-888-5900
Mailing Address - Street 1:2139 TAPO ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3476
Mailing Address - Country:US
Mailing Address - Phone:805-888-5900
Mailing Address - Fax:805-624-8181
Practice Address - Street 1:2139 TAPO ST STE 208
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3476
Practice Address - Country:US
Practice Address - Phone:805-791-3055
Practice Address - Fax:805-791-3059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based