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General NPI Number Information
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NPI Number | 1013299817
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Entity Type | Organization
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Legal Business Name | YUMA REGIONAL CANCER CENTER, LLC
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 2375 S RIDGEVIEW DR
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City | YUMA
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State | AZ
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Zip | 85364-8868
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Country | US
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Telephone | 928-317-2518
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Fax | 928-317-1811
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Provider Business Mailing Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7127
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Country | US
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Telephone | 928-317-2518
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Fax | 928-317-1811
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Authorized Official
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Title or Position | PRACTICE SUPERVISOR
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Name | RONDA SEUBERT
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Credential |
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Telephone | 928-317-2518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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