Provider Demographics
NPI:1962634972
Name:CENTER FOR INTEGRATIVE CANCER TREATMENT, INC.
Entity Type:Organization
Organization Name:CENTER FOR INTEGRATIVE CANCER TREATMENT, INC.
Other - Org Name:OASIS OF HOPE CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-574-1610
Mailing Address - Street 1:6 HUGHES
Mailing Address - Street 2:SUITE 120
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2059
Mailing Address - Country:US
Mailing Address - Phone:949-680-1881
Mailing Address - Fax:949-581-4090
Practice Address - Street 1:6 HUGHES
Practice Address - Street 2:SUITE 120
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2059
Practice Address - Country:US
Practice Address - Phone:949-680-1881
Practice Address - Fax:949-581-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology