Provider Demographics
NPI:1053994038
Name:ANGELS HOPE HOSPICE OF SOUTHERN CALIFORNIA
Entity type:Organization
Organization Name:ANGELS HOPE HOSPICE OF SOUTHERN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMVALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-296-0885
Mailing Address - Street 1:1141 N BRAND BLVD STE 309
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3661
Mailing Address - Country:US
Mailing Address - Phone:818-296-0885
Mailing Address - Fax:818-240-4667
Practice Address - Street 1:1141 N BRAND BLVD STE 309
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3661
Practice Address - Country:US
Practice Address - Phone:818-296-0885
Practice Address - Fax:818-240-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based