Provider Demographics
NPI:1770123945
Name:AMERICAN GUARDIAN HOSPICE
Entity type:Organization
Organization Name:AMERICAN GUARDIAN HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-925-8225
Mailing Address - Street 1:237 ESTUDILLO AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4723
Mailing Address - Country:US
Mailing Address - Phone:510-878-9711
Mailing Address - Fax:510-878-9772
Practice Address - Street 1:237 ESTUDILLO AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4723
Practice Address - Country:US
Practice Address - Phone:510-878-9711
Practice Address - Fax:510-878-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based