Provider Demographics
NPI:1104345818
Name:KATTLEYA HOSPICE AND PALLIATIVE CARE, INC.
Entity type:Organization
Organization Name:KATTLEYA HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:PULANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-200-0664
Mailing Address - Street 1:4959 PALO VERDE ST STE 106-B
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2331
Mailing Address - Country:US
Mailing Address - Phone:909-267-9762
Mailing Address - Fax:909-675-7691
Practice Address - Street 1:4959 PALO VERDE ST STE 106-B
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2331
Practice Address - Country:US
Practice Address - Phone:909-267-9762
Practice Address - Fax:909-675-7691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty