Active NPI
Northern California Radiation Therapists & Oncologists Medical Group
- Radiation Oncology Physician
- Daly City, CA
National Provider Identifier
1053595447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- G12439
- Legal business name
- NORTHERN CALIFORNIA RADIATION THERAPISTS & ONCOLOGISTS MEDICAL GROUP
- Practice address
- 1900 Sullivan Ave
Radiation Oncology Dept
Daly City, CA 94015-2200 - Phone
- (209) 342-2300
- Fax
- (209) 524-4240
- NPI assigned
- Dec 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Barry M Chauser, MD
- Title
- Medical Director
- Phone
- (209) 342-2300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | G12439 | CA | Primary |
Addresses
Primary practice location
1900 Sullivan Ave
Radiation Oncology Dept
Daly City, CA 94015-2200
Mailing address
4301 N Star Way
Modesto, CA 95356-9262
Phone (209) 342-2300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ86312Z | Medicaid | CA | |
| ZZZ86312Z | Other | CA | BLUE SHIELD |
National Provider Directory
National Provider Directory- Tax ID family
- Northern California Radiation Therapists Oncologists Medical Group
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Radiation Oncology Physician
- San Francisco, CA
- NPI 1972785160
-
- Radiation Oncology Physician
- San Francisco, CA
- NPI 1720069891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198195200000",
"number": "1053595447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 N STAR WAY",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569262",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 SULLIVAN AVE",
"address_2": "RADIATION ONCOLOGY DEPT",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940152200",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN CALIFORNIA RADIATION THERAPISTS & ONCOLOGISTS MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-21",
"last_updated": "2007-12-21",
"status": "A",
"authorized_official_last_name": "CHAUSER",
"authorized_official_first_name": "BARRY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "209-342-2300",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "G12439",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ86312Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ86312Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daly City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.