Provider Demographics
NPI:1275838336
Name:CANCER CENTER IMAGING INC.
Entity Type:Organization
Organization Name:CANCER CENTER IMAGING INC.
Other - Org Name:KSK IMAGING CENTER OF IRVINE, KSK BREAST CENTER OF IRVINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOKITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-417-1100
Mailing Address - Street 1:16100 SAND CANYON AVE.
Mailing Address - Street 2:SUITE 130
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3722
Mailing Address - Country:US
Mailing Address - Phone:949-502-3475
Mailing Address - Fax:949-387-4013
Practice Address - Street 1:16100 SAND CANYON AVE STE 130
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3722
Practice Address - Country:US
Practice Address - Phone:949-502-3475
Practice Address - Fax:949-387-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty