Provider Demographics
NPI:1932404613
Name:HOPE4CANCER INSTITUTE
Entity Type:Organization
Organization Name:HOPE4CANCER INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT MANAGER USA
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-988-4673
Mailing Address - Street 1:482 W SAN YSIDRO BLVD # 1582
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-2444
Mailing Address - Country:US
Mailing Address - Phone:619-988-4673
Mailing Address - Fax:
Practice Address - Street 1:650 AVENIDO DE PACIFICO
Practice Address - Street 2:
Practice Address - City:PLAYAS DE TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22504
Practice Address - Country:MX
Practice Address - Phone:619-988-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ2135054261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center