ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP NPI 1316969207

NPI Information

NPI: 1316969207
Provider Name: ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP
Classification: Clinic/Center - 261QX0203X
Entity Type: Organization

Specialization: Oncology, Radiation

CLIA Number: 05D0642663

Address:
1043 ELM AVE
SUITE 110
LONG BEACH, CA
ZIP 90813
Phone: (909) 263-0321
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ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP is an oncology and radiation clinic center in Long Beach, CA. ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP NPI is 1316969207. The provider is registered as an organization entity type.

The provider's business location address is:

1043 ELM AVE
SUITE 110
LONG BEACH, CA
ZIP 90813-271
Phone: (909) 263-0321
Fax: (951) 691-5156

The provider's authorized official is Debby Curry .
The authorized official title is Account Manager and has the following contact phone number (951) 691-5123.

The CLIA number assigned to this NPI record is 05D0642663 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 3/26/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QX0203X	Clinic/Center	Oncology, Radiation	A23750	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W13975	MEDICARE PIN	CALIFORNIA
2	ZZZ5444Z	OTHER	CALIFORNIA	BLUE SHIELD
3	GR0077720	MEDICAID	CALIFORNIA

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

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