Organization
VIRGINIA CANCER INSTITUTE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO M GONZALEZ M.D. (MANAGING PARTNER)
(804) 391-4171
Entity
Organization
Contact information
Practice address
8007 DISCOVERY DR STE A, RICHMOND, VA 23229-8605
(804) 287-3000
(804) 673-2731
Mailing address
7202 GLEN FOREST DR, SUITE 200, RICHMOND, VA 23226-3781
(804) 391-4171
(804) 200-6229
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM1776
RR MEDICARE
VA
Enumeration date
05/12/2006
Last updated
02/16/2024
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