Provider Demographics
NPI:1770163677
Name:LORIAN HEALTH HOSPICE, LOS ANGELES, INC.
Entity type:Organization
Organization Name:LORIAN HEALTH HOSPICE, LOS ANGELES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUMADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-210-4819
Mailing Address - Street 1:9325 SKY PARK CT STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4368
Mailing Address - Country:US
Mailing Address - Phone:619-210-4819
Mailing Address - Fax:
Practice Address - Street 1:633 WEST FIFTH STREET, 26TH FLOOR
Practice Address - Street 2:2628
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-2005
Practice Address - Country:US
Practice Address - Phone:619-210-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based