Age Hospice Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AGE HOSPICE CARE

Practice address

16430 Vanowen St Ste 205
Lake Balboa, CA 91406-4729

Phone

(747) 245-9866

NPI assigned

May 17, 2021

Last updated

May 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gurgen Sargsyan

Title

Ceo

Phone

(747) 245-9866

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1326612037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16430 VANOWEN ST STE 205",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 VANOWEN ST STE 205",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064729",
            "telephone_number": "747-245-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "SARGSYAN",
        "authorized_official_first_name": "GURGEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-245-9866"
    },
    "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 Lake Balboa, CA
• Providers in Lake Balboa, 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 May 17, 2021; 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.