V. VONGTAMA MD INC NPI 1386784114

NPI Information

NPI: 1386784114
Provider Name: V. VONGTAMA MD INC

Doing Business As: ST. TERESA COMPREHENSIVE CANCER CENTER

Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
4722 QUAIL LAKES DR
STOCKTON, CA
ZIP 95207
Phone: (209) 472-1848
Get Directions

V. VONGTAMA MD INC 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. V. VONGTAMA MD INC NPI is 1386784114. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As St. Teresa Comprehensive Cancer Center.

The provider's business location address is:

4722 QUAIL LAKES DR
STOCKTON, CA
ZIP 95207-244
Phone: (209) 472-1848
Fax: (209) 472-0133

The provider's authorized official is Vitune Vongtama .
The authorized official title is Owner and has the following contact phone number (209) 472-1848.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 8/21/2014.

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	2085R0001X	Radiology	Radiation Oncology	A29753	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	00A297530	MEDICAID	CALIFORNIA
2	ZZZ30020Z	MEDICARE ID-TYPE UNSPECIFIED

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: 5/5/2024

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