CANCER CARE ASSOCIATES MEDICAL GROUP INC (NPI# 1104813187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104813187 |
| Entity Type | Organization |
| Organization Name | CANCER CARE ASSOCIATES MEDICAL GROUP INC |
| Other Organization Name | CANCER CARE ASSOCIATES CLINICAL LABORATORY |
| 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 | 2005-10-04 |
| 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 | 291U00000X | Clinical Medical Laboratory | CA | Laboratories |
| Other Name | Type Code |
|---|---|
| Cancer Care Associates Clinical Laboratory | Other Name - Individual/Organization |
| 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 |
| 1033108923 | Cancer Care Associates Medical Group Inc | Internal Medicine | 514 N Prospect Ave, 4th Floor, Redondo Beach, CA 90277-3040 | 2005-10-14 |
| 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 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 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.