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General NPI Number Information
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NPI Number | 1154282127
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Entity Type | Organization
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Legal Business Name | CANCER AND BLOOD SPECIALTY CLINIC
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 3106 PONTE MORINO DR STE B
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City | CAMERON PARK
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State | CA
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Zip | 95682-8281
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Country | US
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Telephone | 530-631-1310
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Fax | 530-631-1311
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Provider Business Mailing Address
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Address Line | PO LOCKBOX 743752
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City | LOS ANGELES
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State | CA
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Zip | 90074-3752
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Country | US
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Telephone | 562-725-4368
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Fax | 562-725-4369
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Authorized Official
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Title or Position | CFO/COO
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Name | ANN T KE
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Credential |
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Telephone | 714-394-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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