| Organization Name: | CANCER CARE ASSOCIATES MEDICAL GROUP INC |
| NPI Number: | 1033108923 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID CHAN (CO OWNER PRESIDENT) |
| Mailing Address: | 514 N Prospect Ave 4th Floor Redondo Beach |
| State: | CA US |
| Postal Code: | 902773040 |
| Phone Number: | 3107503300 |
| Fax Number: | 3107503381 |
| NPI Enumeration Date: | 10/14/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RH0003X |
| License Number: | FNP17913 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Hematology & Oncology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |