MEDICARE: HEMOTHERAPEUTICS, INC.

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1720243876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMOTHERAPEUTICS, INC.

Provider Business Mailing Address
First Line	:	20350 VENTURA BLVD
Second Line	:	SUITE 135
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2452
Country	:	US
Telephone Number	:	818-224-3785
Fax Number	:	818-224-3795

Provider Business Practice Location Address
First Line	:	3150 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1970
Country	:	US
Telephone Number	:	702-878-5800
Fax Number	:	702-878-5890

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MR. HAL LIEBERMAN
Credential	:
Telephone Number	:	818-224-3785

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/28/2008

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