1427390541 NPI number — ANGEL HOSPICE PROVIDERS INC

Table of content: (NPI 1427390541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427390541 NPI number — ANGEL HOSPICE PROVIDERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGEL HOSPICE PROVIDERS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427390541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 S SUNRISE WAY STE 212
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92264-7869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-656-4077
Provider Business Mailing Address Fax Number:
760-656-4737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 S SUNRISE WAY STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92264-7869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-656-4077
Provider Business Practice Location Address Fax Number:
760-656-4737
Provider Enumeration Date:
03/27/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAMUA
Authorized Official First Name:
CLAIRE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
760-656-4077

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 751570 . This is a "PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: C3533951 . This is a "CORPORATION NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".