Organization Active NPI

California Hospice Services, Inc

  • Community Based Hospice Care Agency
  • Norwalk, CA
National Provider Identifier
1194297911
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CALIFORNIA HOSPICE SERVICES, INC
Practice address
12440 Firestone Blvd Ste 1009
Norwalk, CA 90650-4372
Phone
(323) 545-2565
NPI assigned
Dec 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Nitin Verma
Title
Cfo
Phone
(323) 545-2565

Specialties & licenses 1

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

Addresses

Primary practice location

12440 Firestone Blvd Ste 1009
Norwalk, CA 90650-4372

Mailing address

12440 Firestone Blvd Ste 1009
Norwalk, CA 90650-4372
Phone (323) 545-2565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190312003584 CA Part A Provider - Hospice 2062752991 Practice locations: Norwalk, CA

Hospice certification: CCN A01735

Legal name
CALIFORNIA HOSPICE SERVICES, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 27, 2020
Last certification
Feb 27, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Sep 7, 2018 in CA
Enrollment address
12440 Firestone Blvd
Ste 1009
Norwalk, CA 90650-4372

Care Compare: Hospice

Medicare Care Compare
Listed as
California Hospice Services, IncCCN A01735
Ownership
For-Profit
Certified
Feb 27, 2020
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2167575California Hospice Services Inc12440 Firestone Blvd, Ste 1009, Norwalk, CA 90650Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Locations

12440 Firestone Blvd
Ste 1009
Norwalk, CA 90650
Phone (323) 545-2565

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Pin Hung Hsieh Individual Contracted Managing EmployeeMD; Feb 1, 2022
Sonal Jayaswal Individual 5% Or Greater Direct Ownership Interest Nov 1, 2022 75%
Corporate OfficerOwner Nov 1, 2022 75%
Corporate Director Nov 1, 2022 75%
W-2 Managing EmployeeAd; Nov 1, 2024 75%
Navin Jayaswal Individual 5% Or Greater Direct Ownership InterestOwner Feb 16, 2021 25%
Corporate DirectorMember of the Board Feb 16, 2021 25%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1194297911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD STE 1009",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504372",
            "telephone_number": "323-545-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD STE 1009",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504372",
            "telephone_number": "323-545-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA HOSPICE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "NITIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-545-2565"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.