Organization Active NPI

Los Angeles Radiation Oncology Medical Associates

  • Radiation Oncology Physician
  • Tustin, CA
National Provider Identifier
1174594386
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
LOS ANGELES RADIATION ONCOLOGY MEDICAL ASSOCIATES
Practice address
14642 Newport Ave
#470
Tustin, CA 92780-6057
Phone
(714) 573-9500
Fax
(714) 573-9505
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Fontanesi, M.D.
Title
Partner
Phone
(714) 573-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

14642 Newport Ave
#470
Tustin, CA 92780-6057

Mailing address

PO Box 4085
Tustin, CA 92781-4085
Phone (714) 573-9500

Other identifiers 1

IdentifierTypeStateIssuer
GR0092810MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174594386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4085",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927814085",
            "telephone_number": "714-573-9500",
            "fax_number": "714-573-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE",
            "address_2": "#470",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806057",
            "telephone_number": "714-573-9500",
            "fax_number": "714-573-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES RADIATION ONCOLOGY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONTANESI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "714-573-9500",
        "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": "GR0092810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.