VANTAGE CANCER CARE - ARIZONA, S.C. (NPI# 1962804302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962804302 |
| Entity Type | Organization |
| Organization Name | VANTAGE CANCER CARE - ARIZONA, S.C. |
| Practice Address |
1100 Gail Gardner Way Prescott AZ 86305-1690 |
| Mailing Address |
1500 Rosecrans Ave Suite 400 Manhattan Beach CA 90266-3763 |
| Practice Telephone | 9287761040 |
| Mailing Telephone | 3103354000 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |
| Authorized Official Name | DR. LESLIE E. BOTNICK (PRESIDENT) |
| Authorized Official Telephone | 3235955769 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
1100 GAIL GARDNER WAY |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-1690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790773893 | Dhirendra Jashbhai Patel | Radiology | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2005-10-12 |
| 1457753592 | Vantage Cancer Care Network of Arizona, S.c. | Radiology | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2014-09-19 |
| 1841503885 | Northern Arizona Oncology Centers LLC | Internal Medicine | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2010-07-20 |
| 1821210048 | Dhirendra J. Patel, Md, PC | Internal Medicine | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2007-05-03 |
| 1003899816 | Donn Marshall Davis | Specialist | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2005-11-25 |
| 1164411724 | Mukundkumar V Patel | Internal Medicine | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841503885 | Northern Arizona Oncology Centers LLC | Internal Medicine | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2010-07-20 |
| 1821210048 | Dhirendra J. Patel, Md, PC | Internal Medicine | 1100 Gail Gardner Way, Prescott, AZ 86305-1690 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528526472 | Ctca Physicians Group of Arizona, Inc. | Internal Medicine | 3530 S Val Vista Dr Ste C203, Gilbert, AZ 85297-7318 | 2019-03-11 |
| 1184126344 | Ctca Physicians Group of Arizona, Inc. | Internal Medicine | 9755 N 90th St Ste A105, Scottsdale, AZ 85258-5046 | 2018-03-05 |
| 1174882690 | Douglas Robinson | Internal Medicine | 10624 N Crestview Dr, Fountain Hills, AZ 85268-6107 | 2012-05-04 |
| 1528258662 | Joshua Labaer | Internal Medicine | 1001 S Mcallister Ave, Tempe, AZ 85287-0001 | 2007-07-25 |
| 1548349707 | Morris H. Fine | Internal Medicine | 4090 N Painted Quail Pl, Tucson, AZ 85750-6140 | 2006-11-06 |
| 1013954858 | Cochise Oncology LLC | Internal Medicine | 5151 E Highway 90, Sierra Vista, AZ 85635-2436 | 2006-06-01 |
| 1205890530 | William Bruce Ethridge | Internal Medicine | 1951 W 25th Street, Ste F, Yuma, AZ 85364 | 2006-04-13 |
| 1255322871 | Robert Gary Gagliano | Internal Medicine | 203 S Candy Ln, Suite 9a, Cottonwood, AZ 86326-4120 | 2005-11-02 |
| 1417942905 | Nathaniel Fastenberg | Internal Medicine | 6111 E Arbor Ave, Mesa, AZ 85206-6059 | 2005-09-12 |
| 1801397658 | Ctca Physicians Group of Arizona, Inc. | Internal Medicine | 2925 W Rose Garden Ln, Phoenix, AZ 85027-3135 | 2018-02-27 |
| 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.