Healthcare Provider Details

I. General information

NPI: 1508352675
Provider Name (Legal Business Name): ONCOLOGY PHYSICIANS NETWORK OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N BRAND BLVD STE 1000
GLENDALE CA
91203-1966
US

IV. Provider business mailing address

550 N BRAND BLVD STE 1000
GLENDALE CA
91203-1966
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: SRINIDHI VISHWANATH
Title or Position: CEO
Credential:
Phone: 818-507-4732