- Enrollment id
- O20050624000497
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1801939939
- Multiple npi flag
- Y
- Ccn
- 051597
- Associate id
- 8224923081
- Organization name
- VITAS HEALTHCARE CORPORATION OF CALIFORNIA
- Incorporation date
- 1994-11-28
- Incorporation state
- DE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9655 GRANITE RIDGE DRIVE
- Address line 2
- SUITE 300
- City
- SAN DIEGO
- State
- CA
- Zip code
- 921232676