Heart of Angel Hospice & Palliative Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HEART OF ANGEL HOSPICE & PALLIATIVE INC

Practice address

1415 E Colorado St Ste 204
Glendale, CA 91205-1536

Phone

(310) 689-9394

NPI assigned

May 26, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeanie Yoon

Title

Owner

Phone

(310) 689-9394

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B31653

Legal name

HEART OF ANGEL HOSPICE & PALLIATIVE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 31, 2020

Last certification

Oct 31, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 16, 2020 in CA

Enrollment address

405 S San Gabriel Blvd
Ste a
San Gabriel, CA 91776-1968

Listed as

Heart of Angel Hospice & Palliative IncCCN B31653

Certified

Oct 31, 2020

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jilin Bai, M.D.

  • General Practice Physician
  • Monterey Park, CA
  • NPI 1003102856

  Hospice

  Care Compare affiliation
• Peter C CHI, M.D.

  • Family Medicine Physician
  • Temple City, CA
  • NPI 1023090867

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1003439035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E COLORADO ST STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E COLORADO ST STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051536",
            "telephone_number": "310-689-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF ANGEL HOSPICE & PALLIATIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "YOON",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-689-9394"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.