CANCER CARE ASSOCIATES MEDICAL GROUP INC (NPI# 1033108923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033108923 |
| Entity Type | Organization |
| Organization Name | CANCER CARE ASSOCIATES MEDICAL GROUP INC |
| Practice Address |
514 N Prospect Ave 4th Floor Redondo Beach CA 90277-3040 |
| Practice Telephone | 3107503300 |
| Practice Fax Number | 3107503381 |
| Mailing Telephone | 3107503300 |
| Mailing Fax Number | 3107503381 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID CHAN (CO OWNER PRESIDENT) |
| Authorized Official Telephone | 3107503300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
FNP17913 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | ZZZ28793Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528055423 | Cancer Care Associates Medical Group Inc | Clinical Medical Laboratory | 23550 Hawthorne Blvd, Building 1, Suite #160, Torrance, CA 90505-4731 | 2005-10-05 |
| 1942299839 | Cancer Care Associates Medical Group Inc | Internal Medicine | 1360 W 6th St, Ste #315, San Pedro, CA 90732-3581 | 2005-10-14 |
| 1568451417 | Cancer Care Associates Medical Group Inc | Internal Medicine | 23550 Hawthorne Blvd, Building 1 Suite 160, Torrance, CA 90505-4731 | 2005-10-13 |
| 1104813187 | Cancer Care Associates Medical Group Inc | Clinical Medical Laboratory | 514 N Prospect Ave, 4th Floor, Redondo Beach, CA 90277-3040 | 2005-10-04 |
| Street Address |
514 N PROSPECT AVE 4TH FLOOR |
| City | REDONDO BEACH |
| State | CA |
| Zip Code | 90277-3040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033106026 | Chester Walter Gottlieb | Internal Medicine | 514 N Prospect Ave, 4th Floor, Redondo Beach, CA 90277-3040 | 2005-10-04 |
| 1568071157 | Dianne Staso | Dietitian, Registered | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2020-07-29 |
| 1821599564 | Usrc Redondo LLC | Clinic/Center | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2018-02-27 |
| 1487033437 | Arjun Gowda | Internal Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2015-05-22 |
| 1447679865 | Teo Soleymani | Dermatology | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2014-04-14 |
| 1639450638 | Sara Whitacre Johnson | Emergency Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2011-09-02 |
| 1497048060 | Swati Sikaria | Internal Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2011-05-16 |
| 1154622454 | Beverly Chen | Internal Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2010-11-03 |
| 1235447392 | Beach Cities Pain Management Group | Anesthesiology | 514 N Prospect Ave, Ste 100, Redondo Beach, CA 90277-3036 | 2010-09-22 |
| 1770802746 | Ronald Tsao | Internal Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2010-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215103 | Robert John Coffman | Psychologist | 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 | 2020-02-04 |
| 1952949786 | Anne E Pitts | Dietitian, Registered | 360 The Village Drive Unit 207, Redondo Beach, CA 90277 | 2019-12-11 |
| 1558916841 | Dana Bryon Staub | Social Worker | 205 Ave. I, Suite 17, Redondo Beach, CA 90277 | 2019-08-05 |
| 1376033860 | Lisa Ann Graziano | Marriage & Family Therapist | 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 | 2018-05-10 |
| 1275981326 | Carla Marie Vasquez | Marriage & Family Therapist | 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2016-05-31 |
| 1154793628 | Marianne M. Cuttic, Dpm, Inc | Podiatrist | 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 | 2015-10-23 |
| 1841682994 | Mary Schopfel | Counselor | 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2015-02-26 |
| 1700287141 | Rose Ross | Marriage & Family Therapist | 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 | 2014-09-04 |
| 1912307661 | Gale Hazeltine | Physical Therapist | 409 N PCh Hwy # 308, Redondo Beach, CA 90277 | 2014-08-31 |
| 1194135889 | Physical Therapy Concierge Service Inc | Clinic/Center | 704 N. Irena, B, Redondo Beach, CA 90277 | 2014-05-02 |
| Find all providers in zip 90277 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386849974 | Andrew Gabriel Horodner | Internal Medicine | 514 N Prospect Ave Fl 4, Redondo Beach, CA 90277-3040 | 2007-06-15 |
| 1033106026 | Chester Walter Gottlieb | Internal Medicine | 514 N Prospect Ave, 4th Floor, Redondo Beach, CA 90277-3040 | 2005-10-04 |
| 1497048060 | Swati Sikaria | Internal Medicine | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2011-05-16 |
| 1649269465 | Nora Chien Yee Ku | Internal Medicine | 514 N Prospect Ave, 4th Floor, Redondo Beach, CA 90277-3040 | 2005-10-14 |
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|---|---|---|---|---|
| 1750999140 | Kamalesh K Sankhala Md Inc | Internal Medicine | 127 S San Vicente Blvd Fl 7, Los Angeles, CA 90048-3311 | 2020-07-21 |
| 1396365144 | Collin Vu Md, Inc. | Internal Medicine | 10438 Salinas River Cir, Fountain Valley, CA 92708-6841 | 2020-04-22 |
| 1720626757 | Fenix Health Medical Oncology Group PC | Internal Medicine | 72301 Country Club Dr Ste 109, Rancho Mirage, CA 92270-8007 | 2019-12-20 |
| 1871141598 | Edward A, Wagner, M.d., Inc. | Internal Medicine | 25500 Rancho Niguel Rd Ste 240, Laguna Niguel, CA 92677-7373 | 2019-08-27 |
| 1255988341 | Christopher Lemieux | Internal Medicine | 300 Pasteur Dr # H1010, Stanford, CA 94305-2200 | 2019-08-22 |
| 1063972131 | Titfany Wang | Internal Medicine | 133 N Prairie Ave Ste C, Inglewood, CA 90301-4878 | 2019-03-23 |
| 1649736687 | Adventist Health Physicians Network | Internal Medicine | 95 Declaration Dr Ste 1, Chico, CA 95973-4916 | 2019-02-14 |
| 1518433762 | Teamx Medical Group | Internal Medicine | 7253 N Cherry Ln, Van Nuys, CA 91405-5477 | 2018-10-15 |
| 1508352675 | Oncology Physicians Network of California PC | Internal Medicine | 700 N Brand Blvd Ste 640, Glendale, CA 91203-4271 | 2018-07-02 |
| 1881184026 | R.w. Weber, M.d., A Medical Corporation | Internal Medicine | 1800 Sullivan Ave Rm 603, Daly City, CA 94015-2226 | 2018-05-14 |
| Find all providers with the same taxonomy | ||||
| City | REDONDO BEACH |
| Zip Code | 90277 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.