Healthcare Provider Details

I. General information

NPI: 1487754495
Provider Name (Legal Business Name): CAASH CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 W DUARTE ROAD SUITE #5
ARCADIA CA
91007
US

IV. Provider business mailing address

638 W DUARTE ROAD SUITE #5
ARCADIA CA
91007
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-7199
  • Fax: 626-445-7558
Mailing address:
  • Phone: 626-445-7199
  • Fax: 626-445-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7398
License Number StateCA

VIII. Authorized Official

Name: DR. ANGELA FAN-LAN WONG
Title or Position: CEO
Credential: LAC PHD
Phone: 626-445-7199