Organization
VANTAGE CANCER CARE NETWORK OF NEW MEXICO, LLC
Active
Parent organization
VANTAGE CANCER CARE NETWORKS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VANTAGE CANCER CARE NETWORKS, LLC
Authorized official
MR. STEVEN UDICIOUS ESQUIRE (VICE PRESIDENT, GENERAL COUNSEL)
(610) 519-0550
Entity
Organization
Contact information
Practice address
1500 ROSECRANS AVE, SUITE 400, MANHATTAN BEACH, CA 90266-3763
(310) 335-4000
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
10/06/2014
Last updated
10/15/2014
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