Healthcare Provider Details

I. General information

NPI: 1275651515
Provider Name (Legal Business Name): THE ONCOLOGY INSTITUTE CA, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11480 BROOKSHIRE AVE SUITE 309
DOWNEY CA
90241-5018
US

IV. Provider business mailing address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2679
US

V. Phone/Fax

Practice location:
  • Phone: 310-945-8112
  • Fax:
Mailing address:
  • Phone: 562-735-3226
  • Fax: 562-869-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA70830
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471R0002X
TaxonomyRadiation Therapy Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: YALE PODNOS
Title or Position: CMO, OWNER, PRESIDENT
Credential: MD
Phone: 562-735-3226