Active NPI
Angels Hospice Corporation
- Inpatient Hospice
- Chino, CA
National Provider Identifier
1730409806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Inpatient Hospice
- Legal business name
- ANGELS HOSPICE CORPORATION
- Practice address
- 15220 Central Avenue Unit B
Chino, CA 91710-7657 - Phone
- (909) 393-1000
- Fax
- (909) 393-8823
- NPI assigned
- Jun 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Edmeral John De Guzman
- Title
- Ceo
- Phone
- (909) 393-1000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Hospice | 315D00000X | Primary |
Addresses
Primary practice location
15220 Central Avenue Unit B
Chino, CA 91710-7657
Mailing address
15220 Central Avenue Unit B
Chino, CA 91710-7657
Phone (909) 393-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121218000394 | CA | Part A Provider - Hospice | 3375668395 | Practice locations: Chino, CA |
Hospice certification: CCN 551705
- Legal name
- ANGELS HOSPICE CORPORATION
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 23, 2013
- Last certification
- Jul 11, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Mar 20, 2010 in CA
- Enrollment address
- 15220 Central Ave
# B
Chino, CA 91710-7657
Care Compare: Hospice
Medicare Care Compare- Listed as
- Angels Hospice Corporation
- Ownership
- For-Profit
- Certified
- Apr 23, 2013
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
15220 Central Ave
Ste B
Chino, CA 91710
Phone (909) 393-1000
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Maria Eloisa de Leon | W-2 Managing Employee | Aug 1, 2019 | 60% |
| Edmeral John B de Guzman | 5% Or Greater Direct Ownership Interest | Jun 30, 2015 | 100% |
| Corporate Officer | Jun 30, 2015 | 100% | |
| Concepcion Victoria | W-2 Managing Employee | Feb 23, 2015 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
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": "1276128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1549324800000",
"number": "1730409806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15220 CENTRAL AVENUE UNIT B",
"city": "CHINO",
"state": "CA",
"postal_code": "917107657",
"telephone_number": "909-393-1000",
"fax_number": "909-393-8823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15220 CENTRAL AVENUE UNIT B",
"city": "CHINO",
"state": "CA",
"postal_code": "917107657",
"telephone_number": "909-393-1000",
"fax_number": "909-393-8823"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANGELS HOSPICE CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-10",
"last_updated": "2019-02-05",
"status": "A",
"authorized_official_last_name": "DE GUZMAN",
"authorized_official_first_name": "EDMERAL JOHN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "909-393-1000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "315D00000X",
"taxonomy_group": "",
"desc": "Hospice, Inpatient",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.