California Cancer Care A Medical Group INC
Specialist in San Mateo, CA. Organization (NPI-2).
NPI number1619945920
StatusActive
Last updated in NPPESOct 17, 2018
Details
- NPI
- 1619945920
- Entity type
- Organization (NPI-2)
- Legal business name
- California Cancer Care A Medical Group INC
- Organization subpart
- No
- Enumeration date
- Mar 10, 2006
- Last updated
- Oct 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
218 De Anza BlvdSan Mateo, CA 94402-3913
Phone 650-341-9131 · Fax 650-341-9135
Mailing address
218 De Anza BlvdSan Mateo, CA 94402-3913
Phone 650-341-9131 · Fax 650-341-9135
Authorized official
Bradley C Ekstrand
President
6503419131
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