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General NPI Number Information
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NPI Number | 1023402872
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Entity Type | Organization
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Legal Business Name | VICTORY HEMATOLOGY AND ONCOLOGY INC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 4940 VAN NUYS BLVD STE 207
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1700
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Country | US
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Telephone | 818-616-3998
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Fax | 818-688-0138
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Provider Business Mailing Address
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Address Line | 4940 VAN NUYS BLVD STE 207
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1700
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Country | US
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Telephone | 818-616-3998
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Fax | 818-688-0138
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUJIE TANG
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Credential |
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Telephone | 818-651-3819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | A107300
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | A107300
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License Number State | CA
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