EDWARD C GREENLEAF NPI 1346468840

NPI Information

  • NPI: 1346468840
  • Provider Name: EDWARD C GREENLEAF
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Organization
  • Doing Business As: RADIATION ONCOLOGY MEDICAL ASSOCIATES
  • CLIA Number: 05D0864107
  • Address: 2027 GRAND CANAL BLVD STE 25
    STOCKTON, CA
    ZIP 95207
  • Phone: (209) 475-1111

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NPI Details

EDWARD C GREENLEAF is a radiation oncology radiology in Stockton, 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. EDWARD C GREENLEAF NPI is 1346468840. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Radiation Oncology Medical Associates.

The provider's business location address is:

2027 GRAND CANAL BLVD STE 25
STOCKTON, CA
ZIP 95207-650
Phone: (209) 475-1111
Fax: (209) 475-1119

The provider's authorized official is Edward C Greenleaf .
The authorized official title is Medical Director and has the following contact phone number (209) 481-8312.

The CLIA number assigned to this NPI record is 05D0864107 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 6/18/2008.

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
12085R0203XRadiologyTherapeutic RadiologyG51488CALIFORNIANo
22085R0001XRadiologyRadiation OncologyG51488CALIFORNIAYes

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
1ZZZ22481ZMEDICARE PINCALIFORNIA
2GR0044200MEDICAIDCALIFORNIA

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: 3/30/2025

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