Provider Demographics
NPI:1750543740
Name:COAST HEM ONCOLOGY
Entity type:Organization
Organization Name:COAST HEM ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FARACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-516-4295
Mailing Address - Street 1:701 E 28TH ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2759
Mailing Address - Country:US
Mailing Address - Phone:562-997-1239
Mailing Address - Fax:
Practice Address - Street 1:701 E 28TH ST
Practice Address - Street 2:SUITE 418
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2759
Practice Address - Country:US
Practice Address - Phone:562-997-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16014Medicare UPIN