Provider Demographics
NPI:1912583113
Name:LOTUS BLOOM HOSPICE, INC
Entity Type:Organization
Organization Name:LOTUS BLOOM HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGLARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-737-3035
Mailing Address - Street 1:127 S BRAND BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1372
Mailing Address - Country:US
Mailing Address - Phone:747-737-3035
Mailing Address - Fax:
Practice Address - Street 1:127 S BRAND BLVD STE 211
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1372
Practice Address - Country:US
Practice Address - Phone:747-737-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based