Organization
ELITE ONCOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAZAR AL-BUSSAM M.D. (DIRECTOR OF MEDICAL ONCOLOGY)
(310) 397-8654
Entity
Organization
Contact information
Practice address
12099 W WASHINGTON BLVD STE 304, LOS ANGELES, CA 90066-2621
(310) 398-0013
(310) 398-4470
Mailing address
12405 VENICE BLVD # 2, LOS ANGELES, CA 90066-3803
(310) 397-8654
(310) 398-4470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A026479
CA
Other
Enumeration date
12/15/2006
Last updated
08/22/2020
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