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CANCER THERAPY MEDICAL GROUP INC NPI 1649280520


NPI Information

NPI: 1649280520
Provider Name: CANCER THERAPY MEDICAL GROUP INC

Doing Business As: ROHNERT PARK CANCER CENTER

Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
301 PROFESSIONAL CENTER DR
ROHNERT PARK, CA
ZIP 94928
Phone: (707) 584-2200
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CANCER THERAPY MEDICAL GROUP INC is a radiation oncology radiology in Rohnert Park, CA. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. CANCER THERAPY MEDICAL GROUP INC NPI is 1649280520. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Rohnert Park Cancer Center.

The provider's business location address is:

301 PROFESSIONAL CENTER DR
ROHNERT PARK, CA
ZIP 94928-152
Phone: (707) 584-2200
Fax: (707) 584-7582

The provider's authorized official is Jonathan Humphrey .
The authorized official title is Medical Director and has the following contact phone number (925) 952-8700.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 4/4/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0001XRadiologyRadiation OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0092410MEDICAIDCALIFORNIA
2DC7191OTHERRAILROAD MCARE
3ZZZ04964ZOTHERBLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.