1689345431 NPI number — NEW LIGHT HOSPICE AND PALLIATIVE CARE

Table of content: MS. PATRICIA ANN KUCHAR LAC (NPI 1578588505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689345431 NPI number — NEW LIGHT HOSPICE AND PALLIATIVE CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW LIGHT HOSPICE AND PALLIATIVE CARE
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:
1689345431
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3151 CAHUENGA BLVD W STE 224
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90068-1749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-570-3794
Provider Business Mailing Address Fax Number:
818-454-3794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3151 CAHUENGA BLVD W STE 224
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90068-1749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-570-3794
Provider Business Practice Location Address Fax Number:
818-454-3794
Provider Enumeration Date:
09/22/2021

Additional Information

Authorized Official

Authorized Official Last Name:
DAWLATIAN
Authorized Official First Name:
JACK
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
323-570-4012

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)





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