Provider Demographics
NPI:1215510854
Name:MILLENIUM PALLIATIVE CARE, LLC
Entity type:Organization
Organization Name:MILLENIUM PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-828-5658
Mailing Address - Street 1:26940 BASELINE ST STE 106C
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3121
Mailing Address - Country:US
Mailing Address - Phone:323-828-5658
Mailing Address - Fax:909-275-3102
Practice Address - Street 1:26940 BASELINE ST STE 106C
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3121
Practice Address - Country:US
Practice Address - Phone:323-828-5657
Practice Address - Fax:909-275-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based