MEDICARE: UROLOGY CANCER SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION

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	208800000X	Urology Physician	A60294	CA
2	2086X0206X	Surgical Oncology Physician	A60294	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619084316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY CANCER SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	12922 VICTORY BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-2924
Country	:	US
Telephone Number	:	818-760-2800
Fax Number	:	818-760-7343

Provider Business Practice Location Address
First Line	:	12922 VICTORY BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-2924
Country	:	US
Telephone Number	:	818-760-2800
Fax Number	:	818-760-7343

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SOROUSH ADAM RAMIN
Credential	:	M.D.
Telephone Number	:	818-760-2800

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/11/2025

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Directions to “UROLOGY CANCER SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION ” Practice Location

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