Organization Active NPI

California Healthcare and Hospice

  • Community Based Hospice Care Agency
  • Burbank, CA
National Provider Identifier
1063000230
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CALIFORNIA HEALTHCARE AND HOSPICE
Practice address
4405 W Riverside Dr Ste 213
Burbank, CA 91505-4050
Phone
(818) 736-5158
Fax
(818) 484-3407
NPI assigned
Jan 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Emin Khalafian
Title
Ceo
Phone
(818) 736-5158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

4405 W Riverside Dr Ste 213
Burbank, CA 91505-4050

Mailing address

4405 W Riverside Dr Ste 213
Burbank, CA 91505-4050
Phone (818) 736-5158

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL businessemailaddress Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210827000025 CA Part A Provider - Hospice 3678978715 Practice locations: Burbank, CA

Hospice certification: CCN B41711

Legal name
CALIFORNIA HEALTHCARE AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 4, 2022
Last certification
Aug 4, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 2, 2020 in CA
Enrollment address
4405 W Riverside Dr
Ste 213
Burbank, CA 91505-4050

Care Compare: Hospice

Medicare Care Compare
Listed as
California Healthcare and HospiceCCN B41711
Certified
Aug 4, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

4405 W Riverside Dr
Ste 203B
Burbank, CA 91505

4405 W Riverside Dr
Ste 213
Burbank, CA 91505
Phone (818) 736-5158

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Emin Khalafian Individual 5% Or Greater Direct Ownership InterestCeo Nov 2, 2020 50%
Corporate OfficerCeo Nov 2, 2020 50%
Corporate DirectorCeo Nov 2, 2020 50%
W-2 Managing EmployeeCeo Nov 2, 2020 50%
Operational/Managerial ControlCeo Nov 2, 2020 50%
Elvin Khalafian Individual 5% Or Greater Direct Ownership InterestCfo/Secretary Nov 2, 2020 50%
Corporate OfficerCfo/Secretary Nov 2, 2020 50%
Corporate DirectorCfo/Secretary Nov 2, 2020 50%
W-2 Managing EmployeeCfo/Secretary Nov 2, 2020 50%
Operational/Managerial ControlCfo/Secretary Nov 2, 2020 50%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1063000230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 W RIVERSIDE DR STE 213",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054050",
            "telephone_number": "818-736-5158",
            "fax_number": "818-484-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 W RIVERSIDE DR STE 213",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054050",
            "telephone_number": "818-736-5158",
            "fax_number": "818-484-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA HEALTHCARE AND HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "KHALAFIAN",
        "authorized_official_first_name": "EMIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-736-5158"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "businessemailaddress",
            "affiliation": "N",
            "endpointDescription": "CAHealthcareAndHospice@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "4405 W Riverside Dr Ste 213",
            "city": "Burbank",
            "state": "CA",
            "country_code": "US",
            "postal_code": "915054050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.