Healthcare Provider Details

I. General information

NPI: 1265037352
Provider Name (Legal Business Name): OXFORD PHYSICIANS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 09/06/2023
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 BLERIOT AVE
LOS ANGELES CA
90045
US

IV. Provider business mailing address

4712 ADMIRALTY WAY # 941
MARINA DEL REY CA
90292
US

V. Phone/Fax

Practice location:
  • Phone: 310-622-5369
  • Fax: 888-413-9650
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER SOROKURS
Title or Position: ANESTHESIOLOGIST
Credential: M.D.
Phone: 310-622-5369