Organization
OAK TREE MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDMUND WYCOFF BA (ADMINISTRATIVE DIRECTOR)
(626) 577-3415
Entity
Organization
Contact information
Practice address
751 CORDOVA STREET, SUITE #1, PASADENA, CA 91101-2617
(626) 577-2424
(626) 577-2995
Mailing address
751 CORDOVA STREET, SUITE #1, PASADENA, CA 91101-2617
(626) 577-2424
(626) 577-2995
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
CA
2085R0204X
Vascular & Interventional Radiology Physician
—
CA
Other
Enumeration date
09/11/2006
Last updated
08/28/2008
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