1649692351 NPI number — FAMILY FIRST 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 1649692351 NPI number — FAMILY FIRST HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY FIRST 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:
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:
1649692351
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15317 PARAMOUNT BLVD
Provider Second Line Business Mailing Address:
STE 205
Provider Business Mailing Address City Name:
PARAMOUNT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90723-4338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-630-5300
Provider Business Mailing Address Fax Number:
562-630-5301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15317 PARAMOUNT BLVD
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
PARAMOUNT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90723-4338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-630-5300
Provider Business Practice Location Address Fax Number:
562-630-5301
Provider Enumeration Date:
01/15/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FESTEJO
Authorized Official First Name:
MARC LESTER
Authorized Official Middle Name:
DONATO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
562-630-5300

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)