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Organization

MOBILE HOME HEALTH PALLIATIVE & HOSPICE MEDICAL GROUP

Active
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Organization

MOBILE HOME HEALTH PALLIATIVE & HOSPICE MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL S. DAVIDSON (ADMINISTRATOR)
(310) 212-1500
Entity
Organization

Contact information

Practice address
1425 W MANCHESTER AVE STE A, LOS ANGELES, CA 90047-5436
(310) 212-1500
Mailing address
1270 S ALFRED ST UNIT 1064, LOS ANGELES, CA 90035-2506
(310) 212-1500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
251E00000X
Home Health Agency
251F00000X
Home Infusion Agency
251G00000X
Community Based Hospice Care Agency
251J00000X
Nursing Care Agency
251K00000X
Public Health or Welfare Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
332900000X
Non-Pharmacy Dispensing Site
332U00000X
Home Delivered Meals
335G00000X
Medical Foods Supplier

Other

Enumeration date
04/30/2024
Last updated
04/30/2024
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