Wilshire Oncology Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

WILSHIRE ONCOLOGY MEDICAL GROUP, INC.

Practice address

50 Bellefontaine St
Suite 201
Pasadena, CA 91105-3132

Phone

(626) 844-8999

Fax

(626) 844-8995

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Linda Diana Bosserman, MD

Title

President

Phone

(909) 593-4333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1346429362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 ARROW HWY",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505318",
            "telephone_number": "909-593-4333",
            "fax_number": "909-593-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST",
            "address_2": "SUITE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "626-844-8999",
            "fax_number": "626-844-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "BOSSERMAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-593-4333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0002883",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.