Healthcare Provider Details
I. General information
NPI: 1841535655
Provider Name (Legal Business Name): INTEGRATIVE ONCOLOGY STRATEGIES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2012
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2010 INJO DR
LAKE HAVASU CITY AZ
86403-5707
US
IV. Provider business mailing address
4932 SW 55TH PL
OCALA FL
34474-4753
US
V. Phone/Fax
- Phone: 928-453-2636
- Fax: 928-453-2638
- Phone: 925-457-1794
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0203X |
| Taxonomy | Radiation Oncology Clinic/Center |
| License Number | 46711 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
SACHIN
S
KAMATH
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 925-457-1794