NPIMap

Organization Active NPI

Metropolitan Hematology Oncology Medical Group, Inc

  • Hematology & Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1154384758
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C38037 Issued in CA
Legal business name
METROPOLITAN HEMATOLOGY ONCOLOGY MEDICAL GROUP, INC
Practice address
201 S Alvarado Street
Suite 110
Los Angeles, CA 90057-2394
Phone
(213) 484-6474
Fax
(213) 484-8470
NPI assigned
Apr 7, 2006
Last updated
Apr 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Authorized official

Name
Peter Samuel Kennedy, MDNPI 1104882810
Title
President
Phone
(213) 484-6474

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 C38037 CA Primary

Addresses

Primary practice location

201 S Alvarado Street
Suite 110
Los Angeles, CA 90057-2394

Mailing address

PO Box 81172
San Marino, CA 91118-1172
Phone (213) 484-6474

Other identifiers 1

IdentifierTypeStateIssuer
GR0064910MedicaidCA

National Provider Directory

National Provider Directory

Locations

201 S Alvarado St
Ste 110
Los Angeles, CA 90057
Phone (213) 484-6474

Practitioners & affiliated clinicians

Practitioners 9

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1154384758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81172",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911181172",
            "telephone_number": "213-484-6474",
            "fax_number": "213-484-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S ALVARADO STREET",
            "address_2": "SUITE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572394",
            "telephone_number": "213-484-6474",
            "fax_number": "213-484-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN HEMATOLOGY ONCOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-484-6474",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "C38037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0064910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.