NPIMap

Organization Active NPI

Los Angeles Hematology-Oncology Medical Group

  • Non-Pharmacy Dispensing Site
  • Fountain Valley, CA
National Provider Identifier
1730954066
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP
Practice address
11180 Warner Ave Ste 351
Fountain Valley, CA 92708-7516
Phone
(714) 619-4974
Fax
(818) 279-0818
NPI assigned
Nov 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Boris Bagdasarian, DO
Title
Partner
Phone
(818) 696-6994

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

11180 Warner Ave Ste 351
Fountain Valley, CA 92708-7516

Mailing address

541 W Colorado St Ste 320
Glendale, CA 91204-3646
Phone (818) 696-6994

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Hematol Onc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1730954066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST STE 320",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043646",
            "telephone_number": "818-696-6994",
            "fax_number": "818-279-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 351",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087516",
            "telephone_number": "714-619-4974",
            "fax_number": "818-279-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "BAGDASARIAN",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "818-696-6994",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.