Active NPI
Raul R Mena, M.D.
- Hematology & Oncology Physician
- Burbank, CA
National Provider Identifier
1609892256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- G32448
- Practice address
- 181 S Buena Vista St
4RTH Floor
Burbank, CA 91505-4504 - Phone
- (818) 840-0921
- Fax
- (818) 840-7064
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | G32448 | CA | Primary |
Addresses
Primary practice location
181 S Buena Vista St
4RTH Floor
Burbank, CA 91505-4504
Mailing address
PO Box 51194
Los Angeles, CA 90051-5494
Phone (818) 840-0921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OOG324480 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G32448 | CA | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Valley Hematology Oncology Medical Group | Hematology & Oncology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hematology & Oncology Physician
- Burbank, CA
- NPI 1477721868
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1609892256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 51194",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900515494",
"telephone_number": "818-840-0921",
"fax_number": "818-840-7064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 S BUENA VISTA ST",
"address_2": "4RTH FLOOR",
"city": "BURBANK",
"state": "CA",
"postal_code": "915054504",
"telephone_number": "818-840-0921",
"fax_number": "818-840-7064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENA",
"first_name": "RAUL",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "G32448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OOG324480",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.