Provider Demographics
NPI:1548596679
Name:SEBASTIAN HOSPICE CARE INC
Entity type:Organization
Organization Name:SEBASTIAN HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT CARE SERVICE
Authorized Official - Prefix:MISS
Authorized Official - First Name:MINDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-522-5352
Mailing Address - Street 1:1720 E LOS ANGELES AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2033
Mailing Address - Country:US
Mailing Address - Phone:805-522-5352
Mailing Address - Fax:
Practice Address - Street 1:1720 E LOS ANGELES AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2033
Practice Address - Country:US
Practice Address - Phone:805-522-5352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-24
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000458251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551574Medicare Oscar/Certification