Organization
VANTAGE CANCER CARE - ARIZONA, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE E. BOTNICK M.D. (PRESIDENT)
(323) 595-5769
Entity
Organization
Contact information
Practice address
1100 GAIL GARDNER WAY, PRESCOTT, AZ 86305-1690
(928) 776-1040
Mailing address
1500 ROSECRANS AVE, SUITE 400, MANHATTAN BEACH, CA 90266-3763
(310) 335-4000
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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