Provider Demographics
NPI:1649461229
Name:OPTIMAL HOSPICE, INC.
Entity type:Organization
Organization Name:OPTIMAL HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-433-0932
Mailing Address - Street 1:1227 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5445
Mailing Address - Country:US
Mailing Address - Phone:661-410-3000
Mailing Address - Fax:
Practice Address - Street 1:3375 SCOTT BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-3110
Practice Address - Country:US
Practice Address - Phone:408-207-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAL HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-07
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551552Medicare Oscar/Certification