Organization
WILLIAM H. ISACOFF, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM H. ISACOFF M.D. (OWNER)
(310) 824-4133
Entity
Organization
Contact information
Practice address
2811 WILSHIRE BLVD STE 414, SANTA MONICA, CA 90403-4804
(310) 824-4133
(310) 201-6685
Mailing address
2811 WILSHIRE BLVD STE 414, SANTA MONICA, CA 90403-4804
(310) 824-4133
(310) 201-6685
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G24596
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G245960
—
CA
01
—
1487729489
DME NPI
CA
01
—
1891773123
INDIV NPI
CA
01
—
90024B002
TRICARE PROV ID
CA
01
—
ZZZ 66561 Z
BLUE SHIELD OF CA DME
CA
Enumeration date
11/27/2006
Last updated
05/03/2021
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