Provider Demographics
NPI:1982208229
Name:JAYS CANCER CENTER INC
Entity Type:Organization
Organization Name:JAYS CANCER CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BHARADWAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-298-3737
Mailing Address - Street 1:1325 N ROSE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1325 N ROSE DR STE 102
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3800
Practice Address - Country:US
Practice Address - Phone:417-298-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty