Organization Active NPI

California Hematology Oncology Medical Group

  • Hematology & Oncology Physician
  • El Segundo, CA
National Provider Identifier
1831251230
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CALIFORNIA HEMATOLOGY ONCOLOGY MEDICAL GROUP
Practice address
390 N Sepulveda Blvd
1020
El Segundo, CA 90245-4475
Phone
(310) 649-7222
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Authorized official

Name
Viveca Tokatlian
Title
Billing Manager
Phone
(310) 649-7222

Specialties & licenses 1

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

Addresses

Primary practice location

390 N Sepulveda Blvd
1020
El Segundo, CA 90245-4475

Mailing address

390 N Sepulveda Blvd
1020
El Segundo, CA 90245-4475
Phone (310) 649-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001388 CA Part B Supplier - Clinic/Group Practice 1355337288 Receives reassigned benefits from 2 practitioners
Practice locations: El Segundo, CA

National Provider Directory

National Provider Directory

Locations

390 N Pacific Coast Hwy
Ste 1020
El Segundo, CA 90245
Phone (310) 649-7222

Practitioners & affiliated clinicians

Practitioners 2

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": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1831251230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N SEPULVEDA BLVD",
            "address_2": "1020",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454475",
            "telephone_number": "310-649-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N SEPULVEDA BLVD",
            "address_2": "1020",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454475",
            "telephone_number": "310-649-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA HEMATOLOGY ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "TOKATLIAN",
        "authorized_official_first_name": "VIVECA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-649-7222"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.