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LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP NPI 1386859122


NPI Information

NPI: 1386859122
Provider Name: LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 05D2106319

Address:
222 W EULALIA ST
SUITE 100C
GLENDALE, CA
ZIP 91204
Phone: (818) 553-8160
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LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP is a hematology and oncology internal medicine in Glendale, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP NPI is 1386859122. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

222 W EULALIA ST
SUITE 100C
GLENDALE, CA
ZIP 91204-849
Phone: (818) 553-8160
Fax: (818) 553-8152

The provider's authorized official is Boris Bagdasrian .
The authorized official title is Partner and has the following contact phone number (818) 409-0105.

The CLIA number assigned to this NPI record is 05D2106319 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 5/24/2021.


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
1207RH0003XInternal MedicineHematology & OncologyYes

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
1GR0051271MEDICAIDCALIFORNIA

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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