Healthcare Provider Details

I. General information

NPI: 1841456019
Provider Name (Legal Business Name): ANGELES CLINIC AND RESEARCH INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11818 WILSHIRE BLVD SUITE 200
LOS ANGELES CA
90025-6646
US

IV. Provider business mailing address

11800 WILSHIRE BLVD
LOS ANGELES CA
90025-6602
US

V. Phone/Fax

Practice location:
  • Phone: 310-231-2121
  • Fax: 310-231-2199
Mailing address:
  • Phone: 310-231-2121
  • Fax: 310-231-2199

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 Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NANAZ AMINI
Title or Position: ASSOC. DIRECTOR OF PHARMACY SERVICE
Credential: PHARMD
Phone: 310-231-2180