Provider Demographics
NPI:1932852779
Name:CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE, INC.
Entity Type:Organization
Organization Name:CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEDIDIAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-326-1238
Mailing Address - Street 1:PO BOX 25100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5100
Mailing Address - Country:US
Mailing Address - Phone:559-326-1238
Mailing Address - Fax:559-326-1230
Practice Address - Street 1:9850 GENESEE AVE STE 560
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1229
Practice Address - Country:US
Practice Address - Phone:858-552-1410
Practice Address - Fax:559-326-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy