Provider Demographics
NPI:1467233460
Name:PERSONALIZED HEMATOLOGY ONCOLOGY CONSULTANT OF CALIFORNIA PC
Entity Type:Organization
Organization Name:PERSONALIZED HEMATOLOGY ONCOLOGY CONSULTANT OF CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:ARYANPOUR
Authorized Official - Last Name:KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-607-9894
Mailing Address - Street 1:113 WATERWORKS WAY STE 245
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3175
Mailing Address - Country:US
Mailing Address - Phone:949-777-5970
Mailing Address - Fax:949-649-7447
Practice Address - Street 1:113 WATERWORKS WAY STE 245
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3175
Practice Address - Country:US
Practice Address - Phone:949-777-5970
Practice Address - Fax:949-649-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology