Pacific Hospice Care Corporation

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

980001560 Issued in CA

Legal business name

PACIFIC HOSPICE CARE CORPORATION

Practice address

17141 Ventura Blvd Ste 201
Encino, CA 91316-4038

Phone

(213) 382-3825

Fax

(213) 826-1664

NPI assigned

Nov 30, 2005

Organization subpart

No

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

Authorized official

Name

Alexander Boym

Title

Ceo

Phone

(213) 382-3835

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gwendolyn Delosie Sampson Brown, RN, DNP

  • Registered Nurse
  • Rio Vista, CA
  • NPI 1992404495
  NPD

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1730163148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17141 VENTURA BLVD STE 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164038",
            "telephone_number": "213-382-3825",
            "fax_number": "213-386-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17141 VENTURA BLVD STE 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164038",
            "telephone_number": "213-382-3825",
            "fax_number": "213-826-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HOSPICE CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "BOYM",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-382-3835"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "980001560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HPC01768F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Ambulatory Surgical Center
• Pacific Anesthesia Group
• Pacific Coast Anesthesia
• Pacific Coast Childrens Surgery Center LLC
• Pacific Coast Physicians Group, Inc.
• Pacific Ritz Surgery Center, LLC
• Pacific States Medical Center, Apc
• Pacifica Emergency Medical Associates
• Pacifica Emergency Medical Associates, Inc.
• Tabatha Anne Page

• Community Based Hospice Care Agency in Encino, CA
• Providers in Encino, 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 Nov 19, 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.