Healthcare Provider Details

I. General information

NPI: 1548248032
Provider Name (Legal Business Name): COMPASSIONATE CANCER CARE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11180 WARNER AVE STE 351
FOUNTAIN VALLEY CA
92708-7516
US

IV. Provider business mailing address

11180 WARNER AVE STE 351
FOUNTAIN VALLEY CA
92708-7516
US

V. Phone/Fax

Practice location:
  • Phone: 714-698-0300
  • Fax: 714-698-0303
Mailing address:
  • Phone: 714-698-0300
  • Fax: 714-698-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA38872
License Number StateCA

VIII. Authorized Official

Name: DR. HARESH S JHANGIANI
Title or Position: PHYSICIAN./OWNER
Credential: M.D.
Phone: 714-698-0300