Provider Demographics
NPI:1851495501
Name:HEMATOLOGY ONCOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:HERSCHEL
Authorized Official - Last Name:ROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-994-0101
Mailing Address - Street 1:6850 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4451
Mailing Address - Country:US
Mailing Address - Phone:818-994-0101
Mailing Address - Fax:818-994-2126
Practice Address - Street 1:6850 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4451
Practice Address - Country:US
Practice Address - Phone:818-994-0101
Practice Address - Fax:818-994-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0044500Medicaid
CAZZZ31206ZOtherBLUE SHIELD
CAW11063Medicare ID - Type Unspecified
1578667127Medicare PIN
CA6123520001Medicare NSC
CAZZZ31206ZOtherBLUE SHIELD
1619933132Medicare PIN