Provider Demographics
NPI:1316238835
Name:WESTSIDE HOSPICE COMFORTCARE INCORPORATION
Entity type:Organization
Organization Name:WESTSIDE HOSPICE COMFORTCARE INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-284-6637
Mailing Address - Street 1:9555 W. PICO BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1215
Mailing Address - Country:US
Mailing Address - Phone:310-284-6637
Mailing Address - Fax:310-284-8014
Practice Address - Street 1:9555 W. PICO BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1215
Practice Address - Country:US
Practice Address - Phone:310-284-6637
Practice Address - Fax:310-284-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based