Provider Demographics
NPI:1356671762
Name:GLOBAL ONCOLOGY, INC
Entity Type:Organization
Organization Name:GLOBAL ONCOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIISHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-809-0199
Mailing Address - Street 1:1411 S GARFIELD AVE STE 306&308
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5022
Mailing Address - Country:US
Mailing Address - Phone:310-809-0199
Mailing Address - Fax:
Practice Address - Street 1:1411 S GARFIELD AVE STE 306&308
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5022
Practice Address - Country:US
Practice Address - Phone:310-809-0199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63882261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A638820Medicaid
CACV122AMedicare PIN
CA00A638820Medicaid