Organization
PALLIATIVE CARE PROVIDER SOCAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN CORDERO CONTACT PERSON (CONTACT PERSON)
(818) 636-4110
Entity
Organization
Contact information
Practice address
13615 VICTORY BLVD, 120, VAN NUYS, CA 91401-1737
(323) 828-5658
Mailing address
13615 VICTORY BLVD, 120, VAN NUYS, CA 91401-1737
(323) 828-5658
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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