MEDICARE: CITY OF HOPE MEDICAL FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1417968413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF HOPE MEDICAL FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 512185
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0185
Country	:	US
Telephone Number	:	626-775-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1043 ELM AVE
Second Line	:	STE 104
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3271
Country	:	US
Telephone Number	:	562-590-0345
Fax Number	:	562-437-8139

Authorized Official
Title or Position	:	CEO
Name	:	VINCENT JENSEN
Credential	:
Telephone Number	:	626-256-4673

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	01/07/2022

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Directions to “CITY OF HOPE MEDICAL FOUNDATION ” Practice Location

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