Organization Active NPI

Loyalty Hospice Services, Inc.

  • Community Based Hospice Care Agency
  • Anaheim, CA
National Provider Identifier
1821553553
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LOYALTY HOSPICE SERVICES, INC.
Practice address
1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347
Phone
(657) 208-1813
Fax
(714) 333-4638
NPI assigned
Feb 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Procopio T Misa
Title
Authorized Official
Phone
(657) 208-1813

Specialties & licenses 1

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

Addresses

Primary practice location

1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347

Mailing address

1700 E Lincoln Ave Ste 204
Anaheim, CA 92805-4347
Phone (657) 208-1813

Other identifiers 1

IdentifierTypeStateIssuer
C4238324OtherCASECRETARY OF STATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200327002937 CA Part A Provider - Hospice 9436588357 Practice locations: Anaheim, CA

Hospice certification: CCN B41646

Legal name
LOYALTY HOSPICE SERVICES INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 1, 2022
Last certification
Aug 1, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jan 28, 2019 in CA
Enrollment address
1700 E Lincoln Ave
Ste 204
Anaheim, CA 92805-4347

Care Compare: Hospice

Medicare Care Compare
Listed as
Loyalty Hospice Services, IncCCN B41646
Certified
Aug 1, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1700 E Lincoln Ave
Ste 204
Anaheim, CA 92805
Phone (657) 208-1813

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Vinh Buu Individual 5% Or Greater Direct Ownership Interest Dec 29, 2022 100%
Corporate OfficerPresident Dec 29, 2022 100%
Corporate DirectorPresident Dec 29, 2022 100%
W-2 Managing EmployeePresident Dec 29, 2022 100%

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1821553553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E LINCOLN AVE STE 204",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054347",
            "telephone_number": "657-208-1813",
            "fax_number": "714-333-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E LINCOLN AVE STE 204",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054347",
            "telephone_number": "657-208-1813",
            "fax_number": "714-333-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYALTY HOSPICE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "MISA",
        "authorized_official_first_name": "PROCOPIO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "657-208-1813"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "C4238324",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.