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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