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Organization
WILSHIRE ONCOLOGY MEDICAL GROUP, INC.
Active
Organization
WILSHIRE ONCOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA DIANA BOSSERMAN MD (PRESIDENT)
(909) 593-4333
Entity
Organization
Contact information
Practice address
50 BELLEFONTAINE ST, SUITE 201, PASADENA, CA 91105-3132
(626) 844-8999
(626) 844-8995
Mailing address
1502 ARROW HWY, LA VERNE, CA 91750-5318
(909) 593-4333
(909) 593-5588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0002883
—
CA
Enumeration date
10/26/2007
Last updated
05/07/2008
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