Healthcare Provider Details

I. General information

NPI: 1871760926
Provider Name (Legal Business Name): COMPASSIONATE CANCER CARE RADIATION/DIAGNOSTICS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E ONTARIO AVE STE 101
CORONA CA
92879-3514
US

IV. Provider business mailing address

11180 WARNER AVE STE 365
FOUNTAIN VALLEY CA
92708-7516
US

V. Phone/Fax

Practice location:
  • Phone: 951-371-2411
  • Fax: 951-284-0177
Mailing address:
  • Phone: 951-276-2760
  • Fax: 951-276-2960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2471R0002X
TaxonomyRadiation Therapy Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. HARESH JHANGIANI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-371-2411