Wilshire Oncology Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

WILSHIRE ONCOLOGY MEDICAL GROUP, INC.

Practice address

1910 Royalty Dr
Pomona, CA 91767-3021

Phone

(909) 865-9960

Fax

(909) 865-9696

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Linda Diana Bosserman, M.D.

Title

President

Phone

(909) 593-4333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1629098447",
    "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": "1910 ROYALTY DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673021",
            "telephone_number": "909-865-9960",
            "fax_number": "909-865-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-02-25",
        "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_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaunda Williams
• Yvonne Renee Williams
• Aurora Williamsen
• Willow Partners Medical Corp
• Laura Margaret Wills
• Andrew James Wilson, LPT
• Jakaria C Windom
• April Raylene Winter, PSYCH TECH
• Ramy Wissa, BT
• Brandon Witherspoon

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.