MEDICARE: COMPASSIONATE CANCER TREATMENT AND WELLNESS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0203X	Radiation Oncology Clinic/Center

General Provider Information

NPI Number	:	1235562521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CANCER TREATMENT AND WELLNESS CENTER

Provider Business Mailing Address
First Line	:	3701 SACRAMENTO ST # 419
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3151
Country	:	US
Telephone Number	:	415-260-8610
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	JOYCELYN SPEIGHT
Credential	:	M.D., PH.D.
Telephone Number	:	415-260-8610

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	08/29/2013

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