NPIMap

Organization Active NPI

Los Angeles Hematology-Oncology Medical Group

  • Hematology & Oncology Physician
  • Lakewood, CA
National Provider Identifier
1871210708
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP
Practice address
3650 South St Ste 212
Lakewood, CA 90712-1528
Phone
(562) 272-7630
Fax
(562) 272-7631
NPI assigned
Oct 21, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Authorized official

Name
Marla Lou Wsiaki
Title
Project Manager
Phone
(323) 254-0046

Specialties & licenses 1

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

Addresses

Primary practice location

3650 South St Ste 212
Lakewood, CA 90712-1528

Mailing address

541 W Colorado St Ste 205
Glendale, CA 91204-3640
Phone (323) 794-1403

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Hem Onc Med GRP22 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

Locations

541 W Colorado St
Ste 205
Glendale, CA 91204
Phone (323) 254-0046

3650 South St
Ste 212
Lakewood, CA 90712
Phone (562) 272-7630

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1871210708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043640",
            "telephone_number": "323-794-1403",
            "fax_number": "323-488-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 212",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121528",
            "telephone_number": "562-272-7630",
            "fax_number": "562-272-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES HEMATOLOGY-ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "WSIAKI",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "LOU",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "323-254-0046"
    },
    "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 Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.