Healthcare Provider Details

I. General information

NPI: 1437924347
Provider Name (Legal Business Name): THE ONCOLOGY INSTITUTE CA, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 WILSHIRE BLVD STE 900
LOS ANGELES CA
90017-3910
US

IV. Provider business mailing address

18000 STUDEBAKER RD STE 800
CERRITOS CA
90703-2671
US

V. Phone/Fax

Practice location:
  • Phone: 213-481-3948
  • Fax: 424-213-4992
Mailing address:
  • Phone: 562-735-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: YALE DAVID PODNOS
Title or Position: PRESIDENT
Credential: MD
Phone: 562-735-3226