Provider Demographics
NPI:1790308682
Name:BRIGHT ANGEL HOSPICE
Entity type:Organization
Organization Name:BRIGHT ANGEL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURNACHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-205-2552
Mailing Address - Street 1:6044 VINELAND AVE # NUE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4912
Mailing Address - Country:US
Mailing Address - Phone:747-205-2552
Mailing Address - Fax:747-205-2085
Practice Address - Street 1:6044 VINELAND AVE # NUE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4912
Practice Address - Country:US
Practice Address - Phone:747-205-2552
Practice Address - Fax:747-205-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550006924OtherLICENSE
CA630020572OtherFACILITY ID