Provider Demographics
NPI:1477720613
Name:SYNERGY HEMATOLOGY ONCOLOGY MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SYNERGY HEMATOLOGY ONCOLOGY MEDICAL ASSOCIATES, INC.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-525-1111
Mailing Address - Street 1:5901 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4667
Mailing Address - Country:US
Mailing Address - Phone:323-525-1111
Mailing Address - Fax:818-968-3630
Practice Address - Street 1:5363 BALBOA BLVD
Practice Address - Street 2:SUITE 345.
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2805
Practice Address - Country:US
Practice Address - Phone:818-728-8444
Practice Address - Fax:818-728-8440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGY HEMATOLOGY ONCOLOGY MEDICAL ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0084551Medicaid
CAGR0084551Medicaid