Provider Demographics
NPI:1700090388
Name:USC KENNETH NORRIS JR. CANCER HOSPITAL
Entity Type:Organization
Organization Name:USC KENNETH NORRIS JR. CANCER HOSPITAL
Other - Org Name:TENET HEALTHSYSTEM NORRIS INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KANEKO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:323-865-3613
Mailing Address - Street 1:1441 EASTLAKE AVE
Mailing Address - Street 2:ROOM 1355
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-865-3613
Mailing Address - Fax:323-865-0146
Practice Address - Street 1:1441 EASTLAKE AVE.
Practice Address - Street 2:ROOM 1355
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-865-3613
Practice Address - Fax:323-865-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46631261QX0200X, 284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Not Answered284300000XHospitalsSpecial Hospital