NPIMap

Organization Active NPI

Cancer Center Oncology Medical Group, Inc - East County

  • Specialist
  • La Mesa, CA
National Provider Identifier
1497737183
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G26407 Issued in CA
Legal business name
CANCER CENTER ONCOLOGY MEDICAL GROUP, INC - EAST COUNTY
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 644-3030
Fax
(619) 644-3638
NPI assigned
Nov 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Mrs. Debbie Mason
Title
Office Manager
Phone
(619) 644-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G26407 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone (619) 644-3030

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ40281ZOtherCAGROUP BLUE SHIELD
GR0057640MedicaidCA

Other names 1

  • Cancer Center Oncology Medical Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000659 CA Part B Supplier - Clinic/Group Practice 8022095868 Receives reassigned benefits from 8 practitioners
Practice locations: La Mesa, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1497737183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-644-3030",
            "fax_number": "619-644-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-644-3030",
            "fax_number": "619-644-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CENTER ONCOLOGY MEDICAL GROUP, INC - EAST COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-644-3030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G26407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BLUE SHIELD",
            "identifier": "ZZZ40281Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Center Oncology Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.