California Cancer Care Medical Group

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

CALIFORNIA CANCER CARE MEDICAL GROUP

Practice address

1325 Melrose Ave
Suite a
Modesto, CA 95350-5508

Phone

(209) 524-7000

Fax

(209) 527-5601

NPI assigned

May 19, 2006

Last updated

Feb 11, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mussa Banisadre, MDNPI 1043264690

Title

Medical Doctor

Phone

(209) 524-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mussa Banisadre, MD

  • Hematology & Oncology Physician
  • Modesto, CA
  • NPI 1043264690
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1033163688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 MELROSE AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505508",
            "telephone_number": "209-524-7000",
            "fax_number": "209-527-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 MELROSE AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505508",
            "telephone_number": "209-524-7000",
            "fax_number": "209-527-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CANCER CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "BANISADRE",
        "authorized_official_first_name": "MUSSA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "209-524-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vianey M Calderon
• Vince Calderon
• Saphire Destiny Caldwell
• Savannah Nicole Calhoun, PA
• William Calibro
• California Center for Pain and Wellness PC
• California Clinical Care Home Health Services LLC
• California Physical, Occupational, Speech & Hand Therapy, Inc. (California Rehabilitation)
• California Physical, Occupational, Speech and Hand Therapy, Inc. (California Rehabilittion)
• California Physicians Eyecare Group, P.C.

• Hematology & Oncology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.