Basic Information
| Provider Information | |||||||||
| NPI: | 1851416374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CITY OF HOPE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 DUARTE RD | ||||||||
| Address2: | |||||||||
| City: | DUARTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910103012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262564673 | ||||||||
| FaxNumber: | 6269305362 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 DUARTE RD | ||||||||
| Address2: | |||||||||
| City: | DUARTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910103012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262564673 | ||||||||
| FaxNumber: | 6269305362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SALMON | ||||||||
| AuthorizedOfficialFirstName: | MARIA | ||||||||
| AuthorizedOfficialMiddleName: | ELENITA | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL ONCOLOGY NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 6262564673 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | CA | Y | Hospitals | Special Hospital |
ID Information
| ID | Type | State | Issuer | Description | MS 1107110 | 01 | CA | DEA NUMBER | OTHER | NP13938 | 01 | CA | NP FURNISHING NUMBER | OTHER |