Provider Demographics
NPI:1225314362
Name:AFFILIATED ONCOLOGISTS, LLC
Entity Type:Organization
Organization Name:AFFILIATED ONCOLOGISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, MANAGED CARE AND PHYSICIAN SERV
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-335-4093
Mailing Address - Street 1:PO BOX 10050
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90267-7550
Mailing Address - Country:US
Mailing Address - Phone:310-335-4000
Mailing Address - Fax:310-335-4098
Practice Address - Street 1:4400 W 95TH ST
Practice Address - Street 2:SUITE 311
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2654
Practice Address - Country:US
Practice Address - Phone:310-335-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty