NPIMap

Organization Active NPI

City of Hope Medical Foundation

  • Hematology & Oncology Physician
  • Long Beach, CA
National Provider Identifier
1417968413
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CITY OF HOPE MEDICAL FOUNDATION
Practice address
1043 Elm Ave
Ste 104
Long Beach, CA 90813-3271
Phone
(562) 590-0345
Fax
(562) 437-8139
NPI assigned
Aug 11, 2006
Last updated
Jan 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Authorized official

Name
Vincent Jensen
Title
Ceo
Phone
(626) 256-4673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

1043 Elm Ave
Ste 104
Long Beach, CA 90813-3271

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185
Phone (626) 775-3200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com Direct CITY OF HOPE MEDICAL FOUNDATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040417000523 CA Part B Supplier - Clinic/Group Practice 0749275808 Receives reassigned benefits from 30 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Irvine, CA; Torrance, CA; Newport Beach, CA; Long Beach, CA; Huntington Beach, CA; Glendale, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
City of Hope Med Foundation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1417968413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185",
            "telephone_number": "626-775-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 ELM AVE",
            "address_2": "STE 104",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133271",
            "telephone_number": "562-590-0345",
            "fax_number": "562-437-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HOPE MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2022-01-07",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-256-4673"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.