Healthcare Provider Details
I. General information
NPI: 1851495501
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2006
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6850 SEPULVEDA BLVD SUITE 211
VAN NUYS CA
91405-4451
US
IV. Provider business mailing address
6850 SEPULVEDA BLVD SUITE 211
VAN NUYS CA
91405-4451
US
V. Phone/Fax
- Phone: 818-994-0101
- Fax: 818-994-2126
- Phone: 818-994-0101
- Fax: 818-994-2126
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STANLEY
HERSCHEL
ROSSMAN
Title or Position: DOCTOR PARTNER
Credential: MD
Phone: 818-994-0101