Vantage Cancer Care Network Of New Mexico, LLC
Internal Medicine, Medical Oncology in Manhattan Beach, CA. Organization (NPI-2).
NPI number1972906873
StatusActive
Last updated in NPPESOct 15, 2014
Details
- NPI
- 1972906873
- Entity type
- Organization (NPI-2)
- Legal business name
- Vantage Cancer Care Network Of New Mexico, LLC
- Organization subpart
- Yes
- Enumeration date
- Oct 6, 2014
- Last updated
- Oct 15, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RX0202X | Internal Medicine, Medical Oncology | – | – | Yes |
| 2085R0001X | – | – |
Practice location
1500 Rosecrans AveSuite 400
Manhattan Beach, CA 90266-3763
Phone 310-335-4000
Mailing address
1500 Rosecrans AveSuite 400
Manhattan Beach, CA 90266-3763
Phone 310-335-4000
Authorized official
Steven Udicious
Vice President, General Counsel
6105190550
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