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
23550 HAWTHORNE BLVD, BUILDING 1 SUITE 160, TORRANCE, CA 90505-4731
(310) 303-7920
(310) 303-7910
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
—
CS0850
RAILROAD MEDICARE
—
01
—
ZZZ28793Z
BLUE SHIELD
—
Enumeration date
10/13/2005
Last updated
08/22/2020
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