Provider Demographics
NPI:1487754495
Name:CAASH CANCER CENTER
Entity type:Organization
Organization Name:CAASH CANCER CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:FAN-LAN
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC PHD
Authorized Official - Phone:626-445-7199
Mailing Address - Street 1:638 W DUARTE ROAD
Mailing Address - Street 2:SUITE #5
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:626-445-7199
Mailing Address - Fax:626-445-7558
Practice Address - Street 1:638 W DUARTE ROAD
Practice Address - Street 2:SUITE #5
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007
Practice Address - Country:US
Practice Address - Phone:626-445-7199
Practice Address - Fax:626-445-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7398171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty