Provider Demographics
NPI:1346638327
Name:ADVANCED THERMAL ASSOCIATES A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ADVANCED THERMAL ASSOCIATES A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STREETER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-697-3182
Mailing Address - Street 1:2811 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4803
Mailing Address - Country:US
Mailing Address - Phone:888-580-5900
Mailing Address - Fax:
Practice Address - Street 1:2811 WILSHIRE BLVD
Practice Address - Street 2:SUITE 860
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4803
Practice Address - Country:US
Practice Address - Phone:888-580-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation