St. Marys Radiation Oncology Medical Group

Primary specialty

Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X

License

A23750 Issued in CA

Legal business name

ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP

Practice address

1043 Elm Ave
Suite 110
Long Beach, CA 90813-3271

Phone

(909) 263-0321

Fax

(951) 691-5156

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Debby Curry

Title

Account Manager

Phone

(951) 691-5123

Specialties & licenses 1

Addresses

Other identifiers 2

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1316969207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 575",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925640575",
            "telephone_number": "951-691-5123",
            "fax_number": "951-691-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 ELM AVE",
            "address_2": "SUITE 110",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133271",
            "telephone_number": "909-263-0321",
            "fax_number": "951-691-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "CURRY",
        "authorized_official_first_name": "DEBBY",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "951-691-5123"
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": "CA",
            "license": "A23750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0077720",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ5444Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina St. Julian
• Lia S St. Junius
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• St. Mary Health Ventures, Inc.
• St. Mary Medical Center
• St. Michael Surgery Center, LLC
• Sarah St.John
• Kei'Sharra Stacy
• Colleen Stafford
• Stages of Play Physical Therapy Inc

• Radiation Oncology Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Radiation Oncology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.