Organization
CANCER CENTER ONCOLOGY MEDICAL GROUP, INC-EAST COUNTY
Active
Other names
Cancer Center Oncology Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE MASON (OFFICE MANAGER)
(619) 644-3030
Entity
Organization
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 644-3030
(619) 644-3638
Mailing address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 644-3030
(619) 644-3083
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G26407
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0057640
—
CA
01
—
ZZZ40281Z
GROUP BLUE SHIELD
CA
Enumeration date
11/17/2005
Last updated
01/29/2019
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