Provider Demographics
NPI:1508883257
Name:BRYSON CANCER CARE INC
Entity Type:Organization
Organization Name:BRYSON CANCER CARE INC
Other - Org Name:BRYSON CANCER CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRYSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-622-0100
Mailing Address - Street 1:5345 W HILLSDALE DR.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5143
Mailing Address - Country:US
Mailing Address - Phone:559-622-0100
Mailing Address - Fax:559-622-0700
Practice Address - Street 1:5345 W HILLSDALE DR.
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5143
Practice Address - Country:US
Practice Address - Phone:559-622-0100
Practice Address - Fax:559-622-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71842207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5358570001Medicare NSC
ZZZ31378ZMedicare PIN