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General NPI Number Information
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NPI Number | 1588613178
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Entity Type | Organization
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Legal Business Name | BLOOD & CANCER GENETICS INSTITUTE
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 35400 BOB HOPE DR 105
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1753
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Country | US
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Telephone | 760-770-4034
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Fax | 760-770-1854
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Provider Business Mailing Address
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Address Line | 35400 BOB HOPE DR SUITE 105
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1772
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Country | US
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Telephone | 760-770-4034
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Fax | 760-770-1854
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Authorized Official
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Title or Position | PRESIDENT
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Name | MURTHY V ANDAVOLU
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Credential | M.D.
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Telephone | 760-770-4034
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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 | AO54407
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License Number State | CA
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