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PACIFIC CANCER MEDICAL CENTER INC NPI 1336113489


NPI Information

NPI: 1336113489
Provider Name: PACIFIC CANCER MEDICAL CENTER INC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D0867202

Address:
1801 W ROMNEYA DR
STE #203
ANAHEIM, CA
ZIP 92801
Phone: (714) 999-1465
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PACIFIC CANCER MEDICAL CENTER INC is a specialist in Anaheim, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PACIFIC CANCER MEDICAL CENTER INC NPI is 1336113489. The provider is registered as an organization entity type.

The provider's business location address is:

1801 W ROMNEYA DR
STE #203
ANAHEIM, CA
ZIP 92801-830
Phone: (714) 999-1465
Fax: (714) 999-1701

The provider's authorized official is Veena Charu .
The authorized official title is President/ Owner and has the following contact phone number (714) 999-1465.

The CLIA number assigned to this NPI record is 05D0867202 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/15/2006 and was last updated on 1/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332900000XNon-Pharmacy Dispensing SiteNo
2174400000XSpecialistA45465CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0093300MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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