Gibraltar Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GIBRALTAR HOSPICE INC

Practice address

22141 Ventura Blvd Ste 301
Woodland Hills, CA 91364-1663

Phone

(818) 880-5500

NPI assigned

Mar 12, 2012

Last updated

Feb 23, 2024By 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

Eric Ezeuka

Title

President

Phone

(805) 526-0355

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720353535. Details of each certification follow.

• CCN 751552 Hospice · Active · Details

Hospice certification: CCN 751552

Legal name

GIBRALTAR HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 13, 2014

Last certification

Feb 1, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Nov 18, 2019 in CA

Enrollment address

22141 Ventura Blvd
Ste 301
Woodland Hills, CA 91364-1663

Listed as

Gibraltar Hospice, IncCCN 751552 · All quality measures

Ownership

For-Profit

Certified

May 13, 2014

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 2

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

Affiliated clinicians 1

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

• Jack N Yu, MD

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1265485684

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1720353535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8656",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913728656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22141 VENTURA BLVD STE 301",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641663",
            "telephone_number": "818-880-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBRALTAR HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "EZEUKA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-526-0355"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghorbanian, DDS, Inc (Woodland Hills Dental Specialists/Aava Dental of Woodland Hills)
• Alla Ghukasyan
• Edward John Giaquinto Jr., PH.D.
• Gibraltar Healthcare Supplies LLC
• Gibraltar Home Health Services, LLC
• Nolan Michael Giehl, M.D.
• Krista Giffin, AMFT
• Maira Gil
• Darin Gilchrist, LMFT
• Mollie Anne Gilfry, MA

• Community Based Hospice Care Agency in Woodland Hills, CA
• Providers in Woodland Hills, 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 Feb 23, 2024; 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.