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General NPI Number Information
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NPI Number | 1013625730
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Entity Type | Organization
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Legal Business Name | PASADENA CYBERKNIFE CENTER, LLC.
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 630 S RAYMOND AVE UNIT 104
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City | PASADENA
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State | CA
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Zip | 91105-3283
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Country | US
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Telephone | 626-768-1021
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Fax | 626-768-1022
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Provider Business Mailing Address
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Address Line | 630 S RAYMOND AVE UNIT 104
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City | PASADENA
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State | CA
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Zip | 91105-3283
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Country | US
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Telephone | 626-768-1021
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Fax | 626-768-1022
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ALBERT MAK
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Credential | MD
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Telephone | 626-768-1021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number |
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License Number State |
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