Basic Information
| Provider Information | |||||||||
| NPI: | 1558691485 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAMUEL OSCHIN CANCER CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8700 BEVERLY BLVD. | ||||||||
| Address2: | AC# 1043-4 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104235054 | ||||||||
| FaxNumber: | 3106593928 | ||||||||
| Practice Location | |||||||||
| Address1: | 8700 BEVERLY BLVD. | ||||||||
| Address2: | AC# 1043-4 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104235054 | ||||||||
| FaxNumber: | 3106593928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2009 | ||||||||
| LastUpdateDate: | 12/24/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHANG | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3104230619 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN, MN, AOCN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 645442 | CA | Y | Hospitals | General Acute Care Hospital |
No ID Information.