Healthcare Provider Details

I. General information

NPI: 1700090388
Provider Name (Legal Business Name): USC KENNETH NORRIS JR. CANCER HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 EASTLAKE AVE. ROOM 1355
LOS ANGELES CA
90033
US

IV. Provider business mailing address

1441 EASTLAKE AVE ROOM 1355
LOS ANGELES CA
90033
US

V. Phone/Fax

Practice location:
  • Phone: 323-865-3613
  • Fax: 323-865-0146
Mailing address:
  • Phone: 323-865-3613
  • Fax: 323-865-0146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number46631
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number46631
License Number StateCA

VIII. Authorized Official

Name: DR. KEVIN C. KANEKO
Title or Position: MANAGER
Credential: PHARM.D.
Phone: 323-865-3613