Basic Information
Provider Information
NPI: 1225514508
EntityType: 2
ReplacementNPI:  
OrganizationName: THE ONCOLOGY INSTITUTE CA, A PROFESSIONAL CORPORATION
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName: THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 18000 STUDEBAKER RD STE 800
Address2:  
City: CERRITOS
State: CA
PostalCode: 907032671
CountryCode: US
TelephoneNumber: 5627353226
FaxNumber:  
Practice Location
Address1: 2911 N TENAYA WAY STE 210
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891280464
CountryCode: US
TelephoneNumber: 7023421244
FaxNumber: 7025772542
Other Information
ProviderEnumerationDate: 07/19/2018
LastUpdateDate: 04/08/2022
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: PODNOS
AuthorizedOfficialFirstName: YALE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CMO, OWNER, PRESIDENT
AuthorizedOfficialTelephone: 5627353226
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
261QX0203X  N Ambulatory Health Care FacilitiesClinic/CenterOncology, Radiation
207RH0003X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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