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Organization
CANCER CARE ASSOCIATES MEDICAL GROUP INC
Active
Organization
CANCER CARE ASSOCIATES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHAN MD (CO OWNER PRESIDENT)
(310) 750-3300
Entity
Organization
Contact information
Practice address
514 N PROSPECT AVE, 4TH FLOOR, REDONDO BEACH, CA 90277-3040
(310) 750-3300
(310) 750-3381
Mailing address
514 N PROSPECT AVE, 4TH FLOOR, REDONDO BEACH, CA 90277-3040
(310) 750-3300
(310) 750-3381
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
FNP17913
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ28793Z
BLUE SHIELD
—
Enumeration date
10/14/2005
Last updated
08/22/2020
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