Coastal Radiation Oncology Medical Group, Inc.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.

Practice address

1240 S Westlake Blvd
Suite 103
Westlake Village, CA 91361-1929

Phone

(805) 494-4483

Fax

(805) 494-9555

NPI assigned

Jul 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jonathan R Stella, M.D.

Title

President

Phone

(805) 541-1932

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Westlake Radiation Oncology Medical Center, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Coastal Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Thousand Oaks, CA
  • NPI 1811927999

  O20060501000763

  Same enrollment
• Coastal Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Ventura, CA
  • NPI 1922038009

  O20060501000763

  Same enrollment
• Coastal Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Lompoc, CA
  • NPI 1922038173

  O20060501000763

  Same enrollment
• Coastal Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Simi Valley, CA
  • NPI 1932131158

  O20060501000763

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1083644165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 9697",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900849697",
            "telephone_number": "949-721-6520",
            "fax_number": "949-721-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD",
            "address_2": "SUITE 103",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611929",
            "telephone_number": "805-494-4483",
            "fax_number": "805-494-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "STELLA",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-541-1932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0047020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westlake Radiation Oncology Medical Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiation Oncology Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.