Organization Active NPI

California Cancer Care a Medical Group Inc

  • Specialist
  • San Mateo, CA
National Provider Identifier
1619945920
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CALIFORNIA CANCER CARE A MEDICAL GROUP INC
Practice address
218 De Anza Blvd
San Mateo, CA 94402-3913
Phone
(650) 341-9131
Fax
(650) 341-9135
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Authorized official

Name
Dr. Bradley C Ekstrand, M.D.
Title
President
Phone
(650) 341-9131

Specialties & licenses 1

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

Addresses

Primary practice location

218 De Anza Blvd
San Mateo, CA 94402-3913

Mailing address

218 De Anza Blvd
San Mateo, CA 94402-3913
Phone (650) 341-9131

National Provider Directory

National Provider Directory

Locations

218 De Anza Blvd
San Mateo, CA 94402
Phone (650) 341-9131

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1619945920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 DE ANZA BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023913",
            "telephone_number": "650-341-9131",
            "fax_number": "650-341-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 DE ANZA BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023913",
            "telephone_number": "650-341-9131",
            "fax_number": "650-341-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CANCER CARE A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "EKSTRAND",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-341-9131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.