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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 D BOSSERMAN M.D. (PRESIDENT)
(909) 593-4333
Entity
Organization
Contact information
Practice address
8283 GROVE AVE, SUITE 207, RANCHO CUCAMONGA, CA 91730-3137
(909) 949-2242
(909) 920-9863
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
—
GR0002885
—
CA
Enumeration date
07/31/2005
Last updated
09/27/2012
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