Provider Demographics
NPI:1336431600
Name:AHMC INTERNATIONAL CANCER CENTER A MEDICAL CORPORATION
Entity type:Organization
Organization Name:AHMC INTERNATIONAL CANCER CENTER A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-275-8838
Mailing Address - Street 1:PO BOX 80341
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8341
Mailing Address - Country:US
Mailing Address - Phone:626-571-6108
Mailing Address - Fax:
Practice Address - Street 1:605 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1102
Practice Address - Country:US
Practice Address - Phone:626-571-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36104OtherBUSINESS LICENSE
CA36104OtherBUSINESS LICENSE