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Organization
EAST VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP
Active
Organization
EAST VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN JACOBS M.D. (M.D.)
(818) 840-0921
Entity
Organization
Contact information
Practice address
181 S BUENA VISTA ST, 4RTH FLOOR, BURBANK, CA 91505-4504
(818) 840-0921
(818) 840-7064
Mailing address
PO BOX 51194, LOS ANGELES, CA 90051-5494
(818) 840-0921
(818) 840-7064
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB61363F
—
CA
Enumeration date
02/19/2008
Last updated
04/14/2011
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