Provider Demographics
NPI:1720234081
Name:COMPASSIONATE CANCER CARE RADIATION DIAGNOSTICS GROUP INC
Entity Type:Organization
Organization Name:COMPASSIONATE CANCER CARE RADIATION DIAGNOSTICS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:JHANGIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-371-2411
Mailing Address - Street 1:260 E ONTARIO AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3508
Mailing Address - Country:US
Mailing Address - Phone:951-371-2411
Mailing Address - Fax:951-284-0177
Practice Address - Street 1:260 E ONTARIO AVE STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3508
Practice Address - Country:US
Practice Address - Phone:951-371-2411
Practice Address - Fax:951-284-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAY579Medicare PIN