Healthcare Provider Details
I. General information
NPI: 1609926591
Provider Name (Legal Business Name): USC RADIATION ONCOLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2007
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1441 EASTLAKE AVE USC RADIATION ONCOLOGY NOR G356
LOS ANGELES CA
90089-0112
US
IV. Provider business mailing address
PO BOX 31169
LOS ANGELES CA
90031-0169
US
V. Phone/Fax
- Phone: 323-865-3072
- Fax: 323-865-3037
- Phone: 323-865-3072
- Fax: 323-865-3037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PARVESH
KUMAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 323-865-3072