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General NPI Number Information
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NPI Number | 1346801289
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Entity Type | Organization
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Legal Business Name | COMPASSION BREAST INC
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 9888 GENESEE AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-1205
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Country | US
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Telephone | 858-626-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 8888 CLIFFRIDGE AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-2101
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Country | US
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Telephone | 858-546-0420
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PRESIDENT
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Name | DR. ELAINE TANAKA
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Credential | MD
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Telephone | 858-546-0420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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