Provider Demographics
NPI:1891788766
Name:PEDIATRIC & ADOLESCENT HEMATOLOGY-ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:PEDIATRIC & ADOLESCENT HEMATOLOGY-ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:Z
Authorized Official - Last Name:FINKLESTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-492-1062
Mailing Address - Street 1:2653 ELM AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1652
Mailing Address - Country:US
Mailing Address - Phone:562-492-1062
Mailing Address - Fax:562-595-5296
Practice Address - Street 1:2653 ELM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1652
Practice Address - Country:US
Practice Address - Phone:562-492-1062
Practice Address - Fax:562-595-5296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10347174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37940Medicare UPIN
CAA89021Medicare UPIN
CAWG15236Medicare ID - Type Unspecified