NPIMap

Organization Active NPI

East Valley Hematolgy and Oncology Medical Group Inc.

  • Hematology & Oncology Physician
  • Burbank, CA
National Provider Identifier
1750307278
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G62813 Issued in CA
Legal business name
EAST VALLEY HEMATOLGY AND ONCOLOGY MEDICAL GROUP INC.
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Edwin Jacobs, M.D.NPI 1366462939
Title
Physician
Phone
(818) 840-0921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X G62813 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

National Provider Directory

National Provider Directory

Locations

2601 W Alameda Ave
Ste 210
Burbank, CA 91505
Phone (818) 840-0921

4955 Van Nuys Blvd
#312
Sherman Oaks, CA 91403
Phone (818) 981-4673

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1750307278",
    "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": {
        "organization_name": "EAST VALLEY HEMATOLGY AND ONCOLOGY MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "818-840-0921",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G62813",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 7, 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.

Verify at the official NPI Registry.