Healthcare Provider Details

I. General information

NPI: 1356542013
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA ONCOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N BRAND BLVD SUITE 640
GLENDALE CA
91203-1247
US

IV. Provider business mailing address

700 N BRAND BLVD SUITE 640
GLENDALE CA
91203-1247
US

V. Phone/Fax

Practice location:
  • Phone: 818-507-4732
  • Fax: 818-545-8906
Mailing address:
  • Phone: 818-507-4732
  • Fax: 818-545-8906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LIZA SUAREZ
Title or Position: VP OPERATIONS
Credential:
Phone: 818-507-4732