1114339041 NPI number — UNIQUE CARE LOS ANGELES HOSPICE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114339041 NPI number — UNIQUE CARE LOS ANGELES HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIQUE CARE LOS ANGELES HOSPICE, 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:
6
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:
1114339041
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12750 CENTER COURT DR S STE 240
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CERRITOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90703-8570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-359-2766
Provider Business Mailing Address Fax Number:
855-469-1488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12750 CENTER COURT DR S STE 240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CERRITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90703-8570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-359-2766
Provider Business Practice Location Address Fax Number:
855-469-1488
Provider Enumeration Date:
05/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ESMAIL
Authorized Official First Name:
AMIR JORDAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
657-955-4577

Provider Taxonomy Codes

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

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





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