Organization
JOHN WAYNE CANCER INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART P JACKSON (DIRECTOR, FINANCIAL SERVICES)
(310) 449-5253
Entity
Organization
Contact information
Practice address
1328 22ND ST, SANTA MONICA, CA 90404-2032
(310) 449-5253
Mailing address
2200 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2312
(310) 449-5253
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
332B00000X
CA
Other
Enumeration date
03/02/2007
Last updated
07/28/2009
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