Provider Demographics
NPI:1861738742
Name:ANAHEIM HOSPICE, INC
Entity type:Organization
Organization Name:ANAHEIM HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAVIT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-666-2392
Mailing Address - Street 1:10568 MAGNOLIA AVE STE 109-110
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5864
Mailing Address - Country:US
Mailing Address - Phone:714-955-4762
Mailing Address - Fax:714-955-4752
Practice Address - Street 1:10568 MAGNOLIA AVE STE 109-110
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5864
Practice Address - Country:US
Practice Address - Phone:714-955-4762
Practice Address - Fax:714-955-4752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based