Active Angel Caregiver Agency

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

License

464040257 Issued in CA

Legal business name

ACTIVE ANGEL CAREGIVER AGENCY

Practice address

13605 Heather Way
Hawthorne, CA 90250-6474

Phone

(310) 725-9073

NPI assigned

Oct 6, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Parmodh Pardeep Dutt

Title

Ceo

Phone

(310) 725-9073

Specialties & licenses 1

Addresses

Other names 1

• n/a Doing business as

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1053714972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13605 HEATHER WAY",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506474",
            "telephone_number": "310-725-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13605 HEATHER WAY",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506474",
            "telephone_number": "310-725-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE ANGEL CAREGIVER AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "DUTT",
        "authorized_official_first_name": "PARMODH",
        "authorized_official_middle_name": "PARDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-725-9073",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "CA",
            "license": "464040257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Hawthorne, CA
• Inpatient Hospice in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.