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Organization
PREMIERE ONCOLOGY, A MEDICAL CORPORATION
Active
Organization
PREMIERE ONCOLOGY, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE S ROSEN M.D. (PREISDENT AND CEO)
(310) 633-8400
Entity
Organization
Contact information
Practice address
2020 SANTA MONICA BLVD STE 600, SANTA MONICA, CA 90404-2131
(310) 633-8400
(310) 633-8419
Mailing address
2020 SANTA MONICA BLVD STE 600, SANTA MONICA, CA 90404-2131
(310) 633-8400
(310) 633-8419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A49741
CA
174400000X
Specialist
A52720
CA
174400000X
Specialist
Primary
G73680
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A49741
MEDICAL LICENSE - ROSEN
CA
01
—
A52720
MEDICAL LICENSE - GARCIA
CA
01
—
G73680
MEDICAL LICENSE - CHAP
CA
Enumeration date
05/28/2006
Last updated
08/28/2009
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