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Individual

DR. WILLIAM H. ISACOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

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
90024B002
TRICARE PROV ID
CA
01
953490494
COMMERICAL PROV ID
CA
01
ZZZ 66561 Z
BLUE SHIELD OF CA DME
CA
Enumeration date
01/06/2006
Last updated
05/03/2021
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