Organization
COASTAL HOSPICE OF SOCAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PATRICK SIMBULAN (OWNER/ADMINISTRATOR)
(310) 310-3338
Entity
Organization
Contact information
Practice address
12465 LEWIS ST STE 206, GARDEN GROVE, CA 92840-4657
(951) 310-3338
Mailing address
12465 LEWIS ST STE 206, GARDEN GROVE, CA 92840-4657
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417332057
—
CA
Enumeration date
12/12/2019
Last updated
12/12/2019
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