Provider Demographics
NPI:1215463799
Name:IMMUNO-ONCOLOGY CLINIC INC.
Entity type:Organization
Organization Name:IMMUNO-ONCOLOGY CLINIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-615-2350
Mailing Address - Street 1:2040 E MARIPOSA AVE
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5027
Mailing Address - Country:US
Mailing Address - Phone:213-266-5600
Mailing Address - Fax:562-548-2304
Practice Address - Street 1:2040 E MARIPOSA AVE
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5027
Practice Address - Country:US
Practice Address - Phone:213-266-5600
Practice Address - Fax:562-548-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G33266Medicare UPIN