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PREMIERE ONCOLOGY A MEDICAL CORPORATION NPI 1235186859


NPI Information

NPI: 1235186859
Provider Name: PREMIERE ONCOLOGY, A MEDICAL CORPORATION
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2020 SANTA MONICA BLVD STE 600
SANTA MONICA, CA
ZIP 90404
Phone: (310) 633-8400
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PREMIERE ONCOLOGY, A MEDICAL CORPORATION is a specialist in Santa Monica, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PREMIERE ONCOLOGY, A MEDICAL CORPORATION NPI is 1235186859. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2020 SANTA MONICA BLVD STE 600
SANTA MONICA, CA
ZIP 90404-131
Phone: (310) 633-8400
Fax: (310) 633-8419

The provider's authorized official is Lee S Rosen .
The authorized official title is Preisdent And Ceo and has the following contact phone number (310) 633-8400.

The enumeration date for this NPI number is 5/28/2006 and was last updated on 8/28/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA49741CALIFORNIANo
2174400000XSpecialistA52720CALIFORNIANo
3174400000XSpecialistG73680CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W17316MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPROVIDER GROUP NUMBER
26225930001MEDICARE NSCCALIFORNIA
3A49741OTHERCALIFORNIAMEDICAL LICENSE - ROSEN
4G35932MEDICARE UPINCALIFORNIA
5F69865MEDICARE UPINCALIFORNIA
6G73680OTHERCALIFORNIAMEDICAL LICENSE - CHAP
7F51386MEDICARE UPINCALIFORNIA
8A52720OTHERCALIFORNIAMEDICAL LICENSE - GARCIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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