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General NPI Number Information
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NPI Number | 1750394342
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Entity Type | Organization
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Legal Business Name | CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE, INC.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 7130 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93720-3347
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Country | US
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Telephone | 559-447-4949
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Fax | 559-447-4925
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Provider Business Mailing Address
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Address Line | 104 WOODMONT BLVD STE 500
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City | NASHVILLE
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State | TN
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Zip | 37205-2245
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Country | US
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Telephone | 615-252-7212
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Fax | 559-421-7004
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Authorized Official
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Title or Position | OWNER
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Name | JEDIDIAH M MONSON
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Credential | MD
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Telephone | 615-252-7212
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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 | G74904
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License Number State | CA
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