CALIFORNIA CANCER CARE MEDICAL GROUP (NPI# 1033163688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033163688 |
| Entity Type | Organization |
| Organization Name | CALIFORNIA CANCER CARE MEDICAL GROUP |
| Practice Address |
1325 Melrose Ave Suite A Modesto CA 95350-5508 |
| Practice Telephone | 2095247000 |
| Practice Fax Number | 2095275601 |
| Mailing Telephone | 2095247000 |
| Mailing Fax Number | 2095275601 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-02-11 |
| Authorized Official Name | MR. MUSSA BANISADRE (MEDICAL DOCTOR) |
| Authorized Official Telephone | 2095247000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0057600 | 05 |
| Street Address |
1325 MELROSE AVE SUITE A |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-5508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962677781 | Mussa Banisadre Md Inc | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5581 | 2008-04-23 |
| 1326055880 | Alan Grahl Schaffert | Psychiatry & Neurology | 1325 Melrose Ave, C, Modesto, CA 95350-5581 | 2006-08-01 |
| 1194744136 | Abdol Abbas Mojab | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5508 | 2006-07-19 |
| 1043264690 | Mussa Banisadre | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5508 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962677781 | Mussa Banisadre Md Inc | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5581 | 2008-04-23 |
| 1740354331 | Megumi Tomita | Internal Medicine | 4601 Dale Rd, Modesto, CA 95356-9718 | 2006-11-17 |
| 1366520272 | Belinda C. Ark | Internal Medicine | 4601 Dale Rd, Modesto, CA 95356-9718 | 2006-11-01 |
| 1063500833 | Valley Cancer Medical Group | Internal Medicine | 1401 Spanos Ct, #134, Modesto, CA 95355 | 2006-10-10 |
| 1568473965 | Robert Lee Levy | Internal Medicine | 1401 Spanos Ct, #134, Modesto, CA 95355 | 2006-08-10 |
| 1922019322 | Amarjit Singh Dhaliwal | Internal Medicine | 1401 Spanos Ct, 134, Modesto, CA 95355 | 2006-08-10 |
| 1194744136 | Abdol Abbas Mojab | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5508 | 2006-07-19 |
| 1043264690 | Mussa Banisadre | Internal Medicine | 1325 Melrose Ave, Suite A, Modesto, CA 95350-5508 | 2006-05-19 |
| 1104883644 | David H Adkins | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999140 | Kamalesh K Sankhala Md Inc | Internal Medicine | 127 S San Vicente Blvd Fl 7, Los Angeles, CA 90048-3311 | 2020-07-21 |
| 1396365144 | Collin Vu Md, Inc. | Internal Medicine | 10438 Salinas River Cir, Fountain Valley, CA 92708-6841 | 2020-04-22 |
| 1720626757 | Fenix Health Medical Oncology Group PC | Internal Medicine | 72301 Country Club Dr Ste 109, Rancho Mirage, CA 92270-8007 | 2019-12-20 |
| 1871141598 | Edward A, Wagner, M.d., Inc. | Internal Medicine | 25500 Rancho Niguel Rd Ste 240, Laguna Niguel, CA 92677-7373 | 2019-08-27 |
| 1255988341 | Christopher Lemieux | Internal Medicine | 300 Pasteur Dr # H1010, Stanford, CA 94305-2200 | 2019-08-22 |
| 1063972131 | Titfany Wang | Internal Medicine | 133 N Prairie Ave Ste C, Inglewood, CA 90301-4878 | 2019-03-23 |
| 1649736687 | Adventist Health Physicians Network | Internal Medicine | 95 Declaration Dr Ste 1, Chico, CA 95973-4916 | 2019-02-14 |
| 1518433762 | Teamx Medical Group | Internal Medicine | 7253 N Cherry Ln, Van Nuys, CA 91405-5477 | 2018-10-15 |
| 1508352675 | Oncology Physicians Network of California PC | Internal Medicine | 700 N Brand Blvd Ste 640, Glendale, CA 91203-4271 | 2018-07-02 |
| 1881184026 | R.w. Weber, M.d., A Medical Corporation | Internal Medicine | 1800 Sullivan Ave Rm 603, Daly City, CA 94015-2226 | 2018-05-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.