Provider Demographics
NPI:1275651515
Name:THE ONCOLOGY INSTITUTE CA, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THE ONCOLOGY INSTITUTE CA, A PROFESSIONAL CORPORATION
Other - Org Name:THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO, OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YALE
Authorized Official - Middle Name:
Authorized Official - Last Name:PODNOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-735-3226
Mailing Address - Street 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2679
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:562-869-1281
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:310-945-8112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70830207RH0003X
207RX0202X, 2085R0001X, 2471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A708300Medicaid
CA00A708300Medicaid
CAWA70830EMedicare PIN