1386001261 NPI number — LOS ANGELES HEMATOLOGY ONCOLOGY MEDICAL GROUP

Table of content: NATHALIE TORRES DO (NPI 1538804232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386001261 NPI number — LOS ANGELES HEMATOLOGY ONCOLOGY MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOS ANGELES HEMATOLOGY ONCOLOGY MEDICAL GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386001261
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
541 W COLORADO ST STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91204-3640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-254-0046
Provider Business Mailing Address Fax Number:
323-488-9782

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 WILSON TER STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91206-4073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-409-0105
Provider Business Practice Location Address Fax Number:
866-810-7504
Provider Enumeration Date:
01/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WSIAKI
Authorized Official First Name:
MARLA
Authorized Official Middle Name:
LOU
Authorized Official Title or Position:
PROJECT MANAGER
Authorized Official Telephone Number:
323-254-0046

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  5638537 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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