NPIMap

Organization Active NPI

Los Angeles Hematology Oncology Medical Group

  • Hematology & Oncology Physician
  • Riverside, CA
National Provider Identifier
1053131797
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
LOS ANGELES HEMATOLOGY ONCOLOGY MEDICAL GROUP
Practice address
4500 Brockton Ave Ste 107
Riverside, CA 92501-4006
Phone
(951) 276-2760
NPI assigned
Oct 16, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Boris BagdasarianNPI 1598758062
Title
Ceo
Phone
(818) 409-0105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

4500 Brockton Ave Ste 107
Riverside, CA 92501-4006

Mailing address

541 W Colorado St Ste 205
Glendale, CA 91204-3640

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Hem Onc Med GRP22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1053131797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE STE 107",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014006",
            "telephone_number": "951-276-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES HEMATOLOGY ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "BAGDASARIAN",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-409-0105"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.