Organization
GREATER LOS ANGELES ONCOLOGY MEDICAL CORPORATION
Active
Other names
Los Angeles Oncology Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK HENRY RUNDALL MD (CEO)
(213) 353-0610
Entity
Organization
Contact information
Practice address
1626 W TEMPLE ST, LOS ANGELES, CA 90026-5027
(213) 353-0610
(213) 353-4802
Mailing address
1626 W TEMPLE ST, LOS ANGELES, CA 90026-5027
(213) 353-0610
(213) 353-4802
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2861
RAILROAD MEDICARE
—
01
—
DB1410
RAILROAD MEDICARE
—
05
—
GR0086530
—
CA
05
—
GR0086531
—
CA
05
—
GR0086533
—
CA
05
—
GR0086534
—
CA
01
—
ZZZ08485Z
BLUE SHIELD
CA
Enumeration date
08/11/2006
Last updated
10/11/2011
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