Provider Demographics
NPI:1558691485
Name:SAMUEL OSCHIN CANCER CENTER
Entity Type:Organization
Organization Name:SAMUEL OSCHIN CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MN, AOCN
Authorized Official - Phone:310-423-0619
Mailing Address - Street 1:8700 BEVERLY BLVD.
Mailing Address - Street 2:AC# 1043-4
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-5054
Mailing Address - Fax:310-659-3928
Practice Address - Street 1:8700 BEVERLY BLVD.
Practice Address - Street 2:AC# 1043-4
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-5054
Practice Address - Fax:310-659-3928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645442282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital