Provider Demographics
NPI:1205970407
Name:PRESTIGE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:PRESTIGE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DPCS
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAMONDONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-229-9003
Mailing Address - Street 1:3356 W BALL RD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3702
Mailing Address - Country:US
Mailing Address - Phone:714-229-9003
Mailing Address - Fax:714-229-9009
Practice Address - Street 1:3356 W BALL RD
Practice Address - Street 2:SUITE 216
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3702
Practice Address - Country:US
Practice Address - Phone:714-229-9003
Practice Address - Fax:714-229-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based